I am not sure what is going on with Blogger, but I can't post anything. I found out that I can post by email, so hopefully this works! Now, on to the second half of the Post Peak Medicine post. And don't forget to check him out at Post Peak Medicine.
So far, so good. We've seen that five of Joe's pills and his sleep apnea machine are probably unnecessary, and no permanent harm is likely to result from withdrawing them, although he will suffer some transient withdrawal symptoms during the re-adjustment period. Unfortunately, that is not the case for all of them, so now let's look at the potential harm he could suffer if he is unable to obtain his other medications.
The low dose aspirin which he takes once a day thins his blood slightly and reduces the risk of clots forming which could cause a heart attack or stroke. This is a particular risk for diabetics, and Joe is a Type 2 or non-insulin dependent diabetic. So I would recommend that he continues with his low dose aspirin treatment. Fortunately, if commercial pharmaceutical aspirin is unavailable, there is a herbal alternative which will probably work almost as well: willow bark, from which aspirin was derived in the first place. The willow bark also has pain relieving properties and will help to substitute for his prescription painkillers.
If Joe loses his sedatives and antidepressants, this could present a more serious or even fatal problem. Joe finds his job at the call centre and his financial circumstances rather stressful, and his tranquillisers and antidepressants help him to get through his day. About 25% of the North American population (it's hard to be sure of the exact figure) takes antidepressants, tranquillisers and/or sleeping pills on a regular or semi-regular basis, usually not for any real medical illness, but to help them cope with boredom, unhappiness or employment, domestic or financial stress.
Although Joe doesn't realise it, these are the good times. He has money, a job, a house and a car, there is gas at the gas stations and food in the shops, and the Government pays for a wide range of services for him including police, fire and medical services. If some or all of these go away, Joe will find this new world a strange and frightening place and his stress levels will increase. If his usual anti-stress medications are unavailable, he is likely to self-medicate with alcohol. This what we saw during the collapse of the Soviet Union in the early 1990s, when there was an uptick in the death rate, often from alcohol related conditions and suicides. There are some herbal anti-stress preparations which have some effect, like St John's Wort and Valerian, and which are safer than alcohol, but Joe will find that these don't have the same "kick" as his usual medications.
But Joe's real Achilles heel is his diabetes. Many years of obesity and a high fat, high sugar, high fructose corn syrup diet have damaged Joe's pancreas and metabolic pathways to the point where his body is unable to control his blood sugar levels, and unfortunately, once this damage has occurred, it is irreversible. Even if he reforms his diet and gets down to a normal weight, he will never go back to his pre-diabetic state. Glucose-lowering medications such as Metformin and Glyburide can help to suppress blood sugar levels, but if these go away, there isn't really any alternative, although some herbal preparations such as Ipomoea batatas, Silybum marianum, and Trigonella foenum-graecum probably have a mild effect in improving diabetic control. Over the next few years, the high circulating sugar levels will slowly damage the delicate lining of the small blood vessels throughout Joe's body, making him liable to die prematurely from a heart attack, stroke, kidney failure or gangrene of the legs.
These things are already written into the script for future North American society, so for example, if 2010 was the year of peak obesity, I would expect peak diabetes to occur around 2025 and peak diabetic complications to occur around 2040 – even if no collapse ever occurs.
So if you want to remain healthy post-collapse here's my prescription:
Be psychologically prepared for what might happen. That's probably even more important than physical preparation.
Eat local food, mainly vegetables, get down to a normal body weight, stop smoking (if you smoke), take regular exercise, and reduce your prescription medications to the minimum necessary while you can still do it in a controlled way.
Get all the immunizations you can while they are still available.
Get in a stockpile of essential medications (antibiotics, painkillers, potassium iodide, whatever you or your family take regularly). As long as they are in dry form (tablets, capsules or powder) and you keep them in a cool, dark, dry place, they will store for years and you can ignore the manufacturer's official expiration date.
Avoid having accidents. An ounce of prevention is better than a pound of cure.
Learn to look after yourself when you are sick, and don't rely on the professionals always being there to do it for you, because there may come a day when they aren't.
"Post Peak Medicine" is a family physician in Ontario, Canada