Nothing Says "Global Pandemic" Like Insomnia

** I am not a physician and this blog is NOT intended to replace the advice of a physician, nor am I qualified to diagnose or treat disease, or prescribe medication. This blog suggests over the counter and non-invasive interventions that may help ease the symptoms associated with illness. In the event of severe illness, contact your physician and ask for advice and support. ** 

So here's a thing - the next best thing to a pandemic is getting a cold during one when the symptoms of the virus causing said pandemic can act like...a fucking cold. It's AMAZING how quickly your reason and logic vanish, like mist. Poof. Enter paranoia and the desire to really quickly train your spouse in some old school nursing stuff that went out around the time they discovered that a syringe full of Penicillin could save the world. But I digress.

It occurred to me yesterday that we have become so mentally immune to the effects of disease thanks to medication, vaccines, and our healthcare system (may we be truly grateful) that we have forgotten that for millennia, up until the very recent past, we existed without the benefit of antibiotics and vaccinations - and some of us even survived. OK so maybe sometimes the numbers were not so good. But we did learn some things from our time of slightly more primitive medicine, and some of those things can still be applied today.

First, prevention. Prevention in the age of germ theory is critical. How do we prevent the spread of disease? By following some pretty simple steps.

• Avoid contact with people outside of your immediate circle. Stay 10 feet away from others when you must encounter them. Use barriers (gloves, doggie poop bags, used grocery bags, your sleeve, although it's not as good as the other stuff because I can throw a poop bag in the trash and never touch the outside of it) as a barrier between yourself and any solid surfaces you must touch, like door knobs or faucets or gas pumps. 
• WASH YOUR HANDS with soap and water for at least 30 seconds. I cannot stress this enough. Viruses and bacteria despise soap and water. If you must go out into the public sphere for food or medicine, avoid touching surfaces and do not touch your face. Even at home, wash your hands correctly and often.
• Remove your clothing and shower when you get home, and use sanitizing wipes to clean surfaces you had contact with. If you don't have any wipes, 10ml of bleach to a liter of water (that's 1/4 cup bleach to 2-1/2 cups water) is perfect for solid surfaces. Isopropyl alcohol works also. Peroxide, which has been my favorite, works as well but for this particular virus appears to require a 6 minute contact time, or that's the latest estimate. So 1/4 cup of bleach in 2-1/2 cups of water it is, just bear in mind that not all surfaces can tolerate bleach, which is where the isopropyl alcohol or peroxide come in.
• Quarantine yourself from family members who are showing signs of illness if you are compromised or at high risk. 
• Stay well hydrated. As long as you are well, this can be your regular water and tea routine - avoid coffee, alcohol, sodas, or any other beverage that causes dehydration. If you get sick and are not drinking or eating, switch to electrolyte replacement solutions and MAKE YOURSELF DRINK. 
• Get outside, walk, get sun and fresh air, breathe big, get some rest, nap, take baths, meditate, pray, whatever, in general ***free*** self-care for body and mind and spirit. Read Eckhart Tolle, follow Oprah, etc etc etc. 

OK so you've done everything you can, barricaded yourself in your home, bought out all the elbow noodles and tomato soup cans that were left, fought a little old lady for the last tin of Spam and roll of TP (you really didn't need the TP - you have old t-shirts and know how to wash things, but I digress) - or maybe you have a large stash of dried beans and rice and an instant pot (that may just be us...), and now you have the sniffles.

Or maybe not the sniffles. Or maybe you don't know what you have but you have something. This is the time when, if you're us, you panic, freak out, re-write your wills and then at 3am one of you remembers all these things we USED to do before antibiotics and modern hospitals were a thing, and that person writes them down in a bulleted list, as follows (right after you drop a note in your patient portal to update your physician on your current symptoms and condition):

• Although the evidence is entirely anecdotal at this point, I personally will not use ibuprofen to treat fever or aches and pains if my symptoms look at all like this illness. In fact I've pretty much taken all the ibuprofen and hidden it away for the time being. Maybe someday I will find out that this is bunk, but there's enough of rumor circulating to make it worth caution when there are other things I can take. I use acetaminophen or aspirin, and I take them alternately every 4 hours, so aspirin, then 4 hours later acetaminophen, and so on. If my symptoms become severe this could be switched up as follows (schedule is for example only) 8am aspirin, 10 am acetaminophen, noon aspirin, 2pm acetaminophen and so on - that way I am alternating the medications and taking them each every four hours. I make no promises that my stomach or liver will thank me for this schedule, and it would only be appropriate in the event of severe symptoms, like - for me - a sustained fever over 103.
• Stay hydrated! This is where may begin to I switch to a calorie free (if I am still eating but struggling) electrolyte replacer. These are available in stores or online (I like powdered single packet forms which can just sit on the shelf forever in case of need). 
• BREATHE. Oxygen saves lives. In hospitals after surgery at-risk patients are given this marvelous "breathing machine" as my father called it. It is really called an inspiratory spirometer, and it measures your ability to inhale when healthy (your baseline), which then becomes your goal during your (usually post operative) recovery. Now, chances are you do not have an inspiratory spirometer handy - bonus if you do - grab it and do 10 deep reps four or five times a day, more if you think of it because more won't hurt - but you can still learn to breathe deeply. To wit: Ujjayi Pranayama and also Ujjayi Pranayama but 20 minutes of it.
• Eat! This can be as simple as rice cooked into Congee or Jook using chicken stock and ginger and garlic - or vegetable stock (or just water and tamari and sesame oil if you are me). Look, at the end of the day, whole cultures have survived on rice and not much else for long periods of time, and we're talking here about a week, not the rest of my life. Plus rice gruel is just damn satisfying when I'm ill.

So I've done all that and my symptoms are worsening. My chest feels tight, and like it's filling up with fluid. What will I do? First, call my doctor and report my symptoms and ask for advice. If my doctor feels like I can still be managed at home, there are some old-school tricks I can use to increase my breathing capacity and comfort. If these fail to bring relief, then it't time - at least in my house - to go to the hospital. 

• Chest physiotherapy. For this I may want help if I can get it, although there is self-percussion, or I can easily direct my loved one/housemate/caregiver to a link, preferably before I need it. Possibly we had a discussion here yesterday morning involving this very thing. Right after we updated the wills and initialed all the changes and prepared to send them to the lawyer - that's right, I WROTE YOU ALL OUT! EVERYTHING GOES TO MY CATS! but again, I digress. Where was I? Oh yeah, CPT. This is a method of moving mucous out of the lungs and is often used in conjunction with:
• Postural Drainage. In a facility there are lovely beds that incline and tilt to get your body into a comfortable position. At home, I can use pillows, or well-padded stool or chair. The objective is to find a position where fluid can - and this is gross - move ideally out of your lungs and create room for oxygen. When I feel the urge to cough, I can sit up and cough out whatever's there, then return to the PD position and wait for more crap. I may need to move through positions to find the one that works best. 

If none of these things are bringing relief, call the doctor and head for the hospital. In the current climate, don't bring anything you don't absolutely need. Write important contact and insurance numbers on a piece of paper, but leave your wallet and phone at home. 

That's it man. That's my home treatment plan. Now it's in writing and I can refer people to it, and you can read it and know what I'm planning to do if I NEED to. Maybe I won't. But if I do, we have a plan - and I do love a plan!

Now I am going to go watch a nice movie and crochet multiple versions of The Child, and later I plan to nap. I will take my elderberry syrup (maybe as a shrub with 1 T apple cider vinegar and seltzer for kicks) and add turmeric, ginger and garlic to my breakfast lunch and dinner. Oh! I forgot my favorite intervention! And an old one and one that has some evidence to support its efficacy! 

GET OUTSIDE. Sit on a porch. Breathe in fresh air. Spend the whole flipping day out there if you can. Open windows if the temperature is right. Sit in the sun. Go for a walk even if it's just in your yard.

And know that this, like all crises and crazies, will pass. Even if the entire world gets shaken up and unbalanced, change is a normal and natural part of the cycle of existence. Right now, in this exact moment, what problems do you have? THIS moment. None? None. Take a breath, be grateful for it, and move to the next one. That's all we can do. 

Namaste. 

** I am not a physician and this blog is NOT intended to replace the advice of a physician, nor am I qualified to diagnose or treat disease, or prescribe medication. This blog suggests over the counter and non-invasive interventions that may help ease the symptoms associated with illness. In the event of severe illness, contact your physician and ask for advice and support. **