[HLTH/EDU] Home Nursing For Smallpox

CanadaSue · #1 10-06-2002, 06:00 PM

Smallpox... seems that's all we're hearing about or seeing on the news these days; the possibility of a bioattack using smallpox as a weapon. Should it happen the nation is attacked using the variola virus, (smallpox), before vaccine is readily available to all who want it, we're up creek with a snapped paddle, certainly nationally & perhaps as individuals.

Presuming a scenario of smallpox being disseminated throughout the country, it's difficult to imagine that health types & govt. on any level will be prepared to react quickly enough to contain & control an outbreak, limiting its spread. A lot of reasons for this & not nearly all of them can be tied to however incompetently you may personally feel the government handles crises.

People will be scared, perhaps panic stricken. A single case of smallpox will be/must be considered an attack using a weapon of mass destruction. This means that as well as trying to mobilize to treat a nation, the government has a few other priorities to address.

No matter what your personal feelings about vaccination, allopathic/alternative treatments of all kinds; no matter how well you look after the health of you & your family, it may happen that someone in your family comes down with a case of smallpox.

For any number of very good reasons, you may need to care for your sick, loved one at home. Maybe you feel your family stands a better chance of coming through if you stay isolated from your community. Maybe you're too isolated to easily seek medical help. If the outbreak is widespread, that help may not be there. I expect medical resources would quickly be overwhelmed & you might actually be able to do a better job of nurding your loved one at home?

No nursing training or experience? Don't know much about smallpox? You know more than you think you do & can do much more than you think you can. Depending where you live & your pesonal circumstances, home care of the sick may actually be the best option for a number of reasons.

I'm giving a rough outline here of what I'm going to write over the next week or so. Chapters or whatever you want to call them will deal with ONE major topic. Print out what you need, ignore the rest. Initially I'll deal with 'normal' family circumstances, then try to cover different circumstances. Singles who may need to look after themselves. People who may have pre-existing medical conditions of all sorts. Whatever I can think of. Whatever anyone else can think of that might be useful.

I'll cover physical preparation of your home, yourself & your equipment. I'll also cover mental/emotional preparation. All are vital for both the person doing the caring & the one being cared for. I'll explain what good uses you can put other members of the family too while you're doing the nursing work.

I can't possibly cover every single contingency. I don't care how anyone feels about government 'help', vaccine policy or anything else. I'm simply concerned with the greatest number of people coming through on the other side.

For all the scare stories appearing in the press, for all its bad history, people can & have survived this disease, often with a LOT less care than even the most fumble fingered loved one can provide.

I'm gonna take 15 here & get my writing supplies ready. That would be the last of the Brownies, a double chocolate milk & my cancer sticks. Then, we begin.

Saving yourself & your family is doable.

So let's do it, eh?

momm · #2 10-06-2002, 07:45 PM

CanadaSue...thank you for taking the time to do this. It
is greatly appreciated.

Momm

ohiohippie · #3 10-06-2002, 07:48 PM

Greatly appreciated here also, i know how busy you are CS.
I sure hope your fingers do not tire.

hippie

CanadaSue · #4 10-06-2002, 07:58 PM

There are a number of reasons why someone may choose to care for a person stricken with smallpox at home. There can be both advantages & disadvantages to doing this. In the event of a smallpox crisis, hospitals may quickly become overwhelmed with cases, Even if your loved one is an "early" case, after a few days he may be: 'the 16 yr o M in bed #116. To you, he's Gary, who has a B+ average, plays a mean game of chess & has a wicked sense of humor.

You know your loved one best & as tired as you are, no one else is going to be as concerned about his recovery as you can be, except for others in the family.

Busy hospitals are chaotic. During a crisis there's a sense of urgency in the air, an undercurrent of tension that even the sickest patients pick up. Combine that with the onslaught of new noises, sounds, lights & routines which seemingly are planned for everyone's convenience but the patient's & they're not restful places.

The staff will soon be exhausted. Worn out, probably grieving people get distracted, make mistakes. Oh so can you, but you're likely to be more careful when it's your own you're looking after.

You have no way of knowing what other medical conditions some of the patients sharing your loved ones space may have. Heck, they may not know either & there's no guarantee medical/nursing/lab staff will know. Mistakes happen in crises & your loved one may recover from smallpox, but come home with a nasty long term surprise.

How about the food? If your sick loved one is a picky eater, hospital food combined with a very serious medical conditon may not lead to a good chance of recovery.

Your loved one being nursed at home is in comfortable, familiar surroundings. Restrictions on movement, care he/whe would normally carry out themselves, are better off handled when the person is not trrying to 'absorb' a new environment.

Others in the family will have a great many other responsabilities, depending on how bad the situation gets. Caring for your sick at homes eliminates travel which could put you in dangerous situations, etc. You may not be able to get fuel either. Other family members don't really have to depend on verbal reports of how loved one is. If the person is not TOO sick, they can chat through the walls once in a while. It's frightening for very young ones when a sick family member "disappears" to hospital.

Sure there are disadvantages tyo caring for your own at home. You may not know how. You may not know the disease symptoms or its excpected progression - what will show up when, how badly, etc. You may fear the appearance of complications & feel you're not ready/able to cope. How would you handle a death? A permanent disability?

Let me let everyone in on a secret. No matter how much experience, how much knowledge & training; the best medical & nursing types are constantly second guessing themselves. Did I miss something? Is he REALLY getting better? Was this the best treatment for this person at this time? How can I manage this peson's care along with the other 38 patients I am responsible for? Or for the nurse? How can I feed, bathe, soothe & moniter my 12 patients?

The medical profession has no more experience with smallpox than you do? Still think you can't do it? You're wrong. You can do it & do it well. Best of all, you're doing it with personalized compassion & love. The information you need to know about smallpox can be read & absorbed in a few hours. Stare at all the pictures you can find, ugly as they may seem. They'll familiarize you with what you can expect. And somehow, they're not that ugly, the pox, when they're on YOUR loved one.

Your caring for a person will not necessarily lower their chances for survival. It may in fact, increase it. No one knows one way or another. I know this, speaking as a former RN. I'd far rather my sons, my DH, look after me at home than the most 'professional' staff in the best hospital in a smallpox outbreak. At home, I won;t have to worry about how everyone is doing, I'll know. I can have my tv on if my head doesn't ache too bad & the meals I know I can handle.

Your family deserves that too.

CanadaSue · #5 10-06-2002, 09:23 PM

Right, you're sitting down at your computer, sunlight streaming through the window, favorite pet at your feet & a cup of your favorite brew in front of you. You're generally prepped, your kids are in bed or in school. Everyone is leaving you alone.

Life is good.

You think of smallpox showing up in your town, maybe even in your own home. ? Suddenly, life may not be so good.

Where's that sudden chill coming from? That hair rising on the back of your neck? What is it you're really afraid of? Suddenly, life may not be so good.

Well that depends on you, how well you consider you've prepped. Where you live. Who is there in support of you. We all fear most what we think we can least do well. We fear what we feel we have little or no control over. We fear what we don't know. In new situations we fear we'll be incapable of coping & we fear our own reactions to potentially terrifying events.

There are three aspects to preparing to care for your sick at home; physical, mental & emotional. Physical is easy, really. It's finding & putting together what equipment & supplies you'll need & can come up with. It's making sure yiou are as fit as possible & can maintain your own nutritional status & rest. Not terribly complicated if you're useed to preparing for any likely eventuality & even some not so likely ones.

Mental; that's a matter of knowledge. It's a question of finding the best information you can about the disease, at whatever level you can handle. Websites are geared to research types as well as "what's a thermometer" type 'civilians'. Most of us are somewhere in between. Later I'll list sites that have decent information.

In my opinion, the biggest adjustment we'd have to make in the event of a smallpox outbreak, especially if we're determined to stay home & look after our own, is emotional. That adjustment has several important components to it, most or all of which are vital to you in your dual roles of family care taker/smallpox nurse.

I'm writing this for both mothers & fathers. Sisters, sons, daughters; whoever find themselves in the role of caretaker during a crisis. It may come as a surprise to some families to find that the normal "strong one", the one who nominally runs the family during normal times isn't quite as up to the job during crisis periods. That's not a negative comment or a slur aimed at those people. Not all can rise to the occasion & those that can often are not so great at the day to day stuff of life.

So it doesn't matter who in the family is perfoming the duties of family caregiver, head of the house; as long as someone is. Even better if more than one family member can step into that role.

This is directed to that person, those persons in the family who, from experience or gut feeling, are inclined to think they will be in that role if things get hairy.

So what emotional/attitude adjustments will you have to make in the event of a crisis involving smallpox, possibly involving a widespread outbreak & systems of all sorts breaking down?

First, you're going to have to develop a very thick skin. You may hagve or discover whiners in the family. Laziness. Petulance. Thin skins;sensitive types. And I'm just talking the adults. At least kids are fairly predictable.

You may be stuck with someone in the house who feels their designated role is to question everything you do or, to criticize. Not they THEY have better answers, they just don't like yours. In a crisis, a little bit of tyranny is perfectly acceptable & may be absolutely necessary.

Think it through. You're facing a crisis with many unknowns. You may not be able to count on power, sewage, water, availability of food; that's why you're a prepper, isn't it? You may not be able to trust what's coming across in the media. Be sure the government is as confused about a lot of things as you are. Even with the best intentions & a good amount of talent & experience, they have no time to become everybody's nursemaid.

Neither do you. If you're going to end up looking after a loved one stricken with smallpox, others are going to simply have to carry more of the load at home. You may be peace loving person by nature. You may prefer to think the best of everyone. You may prefer discussion & negotiation to 'laying down the law'. Guess what? You & yours have a far better chance of getting through something like this if you turn into a mini Margaret Thatcher, a Pol Pot; pick your favorite petty dictator.

I'm not telling anyone to turn mean & nasty. You'll all be living under enough stress. But try for "fair, firm & friendly"; emphasis on the firm when necessary. Your role, pre-outbreak, is to learn as much as you can about the disease & to prepare for it as best you can. Once that's done, initially discuss your plans with those in the house willing to listen. What to do about other not so co-operative household members will come up later.

You also have to be right with whatever higher power you personally answer. That Deity is there for YOUR guidance, All you need to do is ask. And listen for the answers. You're gonna need solmeone/something to lean on too. You're not SuperPerson.

You need to spend some time carefully thinking through various potential scenarios & occurances & try to decide how best to deal with them, so that you're not cause surprised when it happens. Will you & yours go for vaccines? Under what circumstances? Would you go to a hospital? Would you let governnment employees into your home? How will you deal with the dying or dead?

Nasty, nasty things to think about. But best to have your fits of the weepies & white nights staring at the moon in a daze then not be ready to deal with these situations. Think about how you react when you're overburdened? Is it healthy? Can you recognize when you're about to lose it? Who can spell you off when you desperately need a break?

These are all deeply personal issues & they vary from person to person, family to family. They're best thought of well in advance of any potential crisis. They can apply to any type of serious crisis. Tryiong to deal with smallpox at home, some of these things are especially vital.

But one thing at a time.

Tomorrow morning, we'll start looking atr setting up a asickroom & equipping it on a budget.

It'sJustMe · #6 10-06-2002, 10:09 PM

I would like to add my thanks to you, CS for starting this thread. It may be a given for many of us who live rurally, that we need to know this kind of information. Some of us may be feeling exactly how you describe, fearing that we might be called upon to give care to our own in a time when we, as a country, might find ourselves in chaos. And feeling less than adequate at the moment, perhaps. Being prepared, just in case, has got to add a peace of mind factor that might prove immeasurable, were we called upon. With prayers and luck, however one looks at it, perhaps we will not need the info. But what if we do? Your time is very much appreciated. It's Just Me

Sammy55 · #7 10-06-2002, 10:25 PM

I too, CSue, thank you for all of your hard work here. I know very little about Smallpox or how to treat it, and I haven't had time to search the internet yet. Too busy getting ready for winter.

But I will seriously sit down with your info and begin to prep for it. And hope that we never have to use the stuff.

Sammy55

O2BNOK · #8 10-06-2002, 10:50 PM

Thanks for this! Great job...

xoxoxo

Kasota · #9 10-06-2002, 11:02 PM

CS, thanks for all your hard work on this. Terrific job.

ainitfunny · #10 10-07-2002, 01:12 AM

There is no plan to admit more than the first few cases of smallpox to a hospital. The emergency response plan calls for hospitals to divert all suspected small pox cases and exposed citizens to a quarrantine facility once it becomes obvious the outbreak is widespread. Those facilities will forcibly isolate all those either exposed or suffering smallpox in stadiums or warehouses predesignated to serve as a quarrantine reception. Little or no treatment is to be provided. I have not heard of massive planning, contingency staffing or medical resource pre-positioning to medically care for those stricken with smallpox, so I am assuming if they do not discuss how they will medically treat a large number of patients in a makeshift quarrantine facility, then THEY DO NOT PLAN TO PROVIDE ANY MEDICALLY SIGNIFICANT TREATMENT.

Be assured, those who are sufficiently IMPORTANT PEOPLE will always be treated differently, but for you and I, it would be most prudent NOT to make the authorities aware of any family member who has fallen ill, and to treat them at home. Better that that to have your WHOLE FAMILY FORCED AT GUNPOINT into some warehouse where you have nothing to work with to try to save your sick loved ones and where you ALL will be exposed to everyone else. Remember, once all the sick people are gathered into one location, it could seem like a "merciful accident" to some disaster Big Shots controlling the situation if the public were told a "natural gas leak and explosion" cut short their suffering.

Remember, at this point we are to remember the military jets are ready to shoot down any commercial airliner posing a threat to public safety, so doing away with a lot of people to "save" the others is not entirely beyond the reasoning of our public officials.

FREEBIRD · #11 10-07-2002, 07:47 AM

Aintitfunny---I agree. A widespread breakout of smallpox isn't going to be treatable by the current hospital system; we have a nursing shortage now, and that would be assuming that current medical staff wouldn't be sick and/or wouldn't have panicked and quit (I have personally known nurses who have stated they would refuse to treat AIDS patients).

CanadaSue---I greatly appreaciate your efforts here! A question---how does the "head caregiver": (A) not get sick themselves, and/or (B) cope with multiiple family members with smallpox? I can easily envision a scenario wherein EVERYBODY in the household gets it. Who does the caretaking then? I do not intend or see this as a facetious question.

CanadaSue · #12 10-07-2002, 07:51 AM

I'm going to cover that & as much else as possible. Right now, just putting together aprimer on the disease itself; what it is, what it does. Look for it in 1/2 an hour or so.

Then I start getting into the nitty gritty...

CanadaSue · #13 10-07-2002, 09:15 AM

The title to this section is not an insult aimed at anyone. With no cases being seen since the 1970s; with few health practitioners left who've ever seen, never mind treated a case, we're ALL smallpox dummies.

Until 9/11, information about smallpox tended to have a historical perspective. Previous outbreaks/epidemics were discussed, but mainly in terms of how they occurred, how transmission was suspected to have happened & how long it took for the outbreaks to end.

Not a whole lot of practical information was available on diagnosis & comparison to other pox type illnesses. Forget treatment information. Readers were told there was no medical treatment & care of patients should be "supportive" in nature. The word supportive doesn't give a whole lot of info, does it? To be honest, it's still difficult to find practical discussions of how to care for patients. A little bit can be found on one site, other things are hinted at on others... it's akin to hunting for needles in haystacks.

Thankfully, knowing the progression of the disease, its symptoms & how/when exactly your patient is going to be feeling rotten can provide some reasonable ideas of what to do for your loved ones. In the days when smallpox was an ongoing concern, most patients were cared for at home anyway; nothing new there. And medical treatment at the time did not significantly improve survival rates or lessen complication rates.

Today, there are still a lot of unknowns about smallpox the disease & its causative organism: variola virus. We don't know exactly how it kills people. Incubation periods are given in ranges, as are complication rates, recovery rates & secondary infection rates. That may not be terribly comforting, but it's honest.

Sickness of this nature is CAUSED by infection by the virus overwhelming various aspects of the body's immune system, but disease & its progression is not purely a 'physical' thing. We all know the power of the mind. 98 pound weaklings lifting cars off people. A new widow almost willing herself to death a few months after her beloved spouse of 37 years passes on. The determination of those 'beyond recovery' to make some recovery & who do.

Physically, a person who's healthy, well nourished, well rested, not terribly stressed out; who leads a balanced life & maintains a good outlook on life has a good chance of overcoming a great many serious illnesses. The reason why doesn't really matter. It may be that a good outlook on life has a positive influence on the metabolic processes involved in immune responses via a biochemical route. It may be relatiely unknown systems of hard to find energies which are positively impacted. Bluntly, who cares? As long as we know that a good base state of physical/mental health improves the odds.

As a prepper, you may choose all sorts of ways to improve your base state of mental/physical wellbeing. Good nutritional status, enough rest & sleep. Proper exercise. If meditation, Tai Chi, cursing out basketball coaches or clutching a teddy bear when you go to sleep at night for you make you feel more secure, more balanced & healthy, then go for it! FEELING you're doing the right thing may be half the battle.

Okay, what do we need to know about smallpox?

It's been around for thousands of years, with the first recorded cases being reported back around 1200 BC. Since it's been with us, it has swept Europe, Asia & Africa in epidemics killing & disfiguring hundreds of millions. It is thought to be the single biggest killer of humans among infectious diseases. In the 20th century alone, it is thought to have killed roughly 300 million people.

It was "officially" eradicated in the 1970s, after the World Health Organization decided it could be eliminated from the human population because, it only infects humans. The last known case occured in Somalia in 1977.

It's a VIRAL disease caused by the variola virus. The only known species on the planet it is known to infect & be TRANSMITTED between is humans. Various web sites state that some monkeys can be infected, but that they cannot pass this on to humans. As this is not particularly relevent to most of us, I haven't really checked into it.

Humans pass it to each other in TWO ways. It is an airborne disease & coughing, sneezing, spitting can spread it. A single coughed up aerosol drop of 'lung crud' theoretically has more than enough virus to infect someone else. Best estimates for the number of individual virus particles needed to infect someone? Best guess is about 50-100 individual virions, the 'proper' name for virus particles. Such coughed up droplets can travel 10 feet through the air. The other way to get it is by touching the pox when they are filled with fluid & leaking or by touching the dried up scab material.

Smallpox infection anywhere today is considered a national level crisis for a couple of reasons. First, not haing seen it for almost 30 years & not having vaccinated for it for at least that same amount of time, few people out there have much if any immunity left. It is thought, (being tested now), that those who were vaccinated as kids or in the armed forces may have some resibual immunity. Some is better than nothing.

Because the disease does not currently exist 'in the wild', a single case outside a lab actively working with smallpox must & WILL be seen as a deliberate attack using a weapon of mass destruction, with all that implies.

The variola virus is highly infectious. Of 100 people exposed, 60 will come down with the disease. Remember, these statistics were collected BEFORE people regularly took anti-rejection drugs, BEFORE HIV & other immune disorders became prevelant. With a population having no exposure to variola virus in the last generation or 2, the numbers MAY be higher. We simply don't know.

WHAT DOES SMALLPOX DO? WHAT ARE THE SYMPTOMS?

There are 2 clinical forms of smallpox. Variola major is the more serious & most common form. The severest manifestations of smallpox fall under this clinical form. The other is variola minor, which is far less serious & has a much lower rate of complications & death.

Variola major has an 'average' case fatality rate of 30%, meaning your 100 original exposed people; of the 60 who get sick, 18 will die. The speecific case fatality rate depends on the STRAIN of variola involved; there are roughly 200 of these. It also depends on where it strikes. A location where people are poorly nourished & may have other endemic diseases is likely to see a higher death rate. There are too lethal variations of variola major. Flatpox or blackpox does not have the charactoristic skin eruptions known as pox. Instead, the skin remains smooth & turns black. The body's immune system is paralysed & thus no pus is produced.. Hence, no pox, no discharge to scab over. The blackened areas are caused by hemmorhaging under the skin & in some cases, the skin sloughs off. These patients almost invariably die.

Hemmorhagic pox acts like any hemmorhagic fever. The body discharges unclotted blood from any/all orifices. The virus can break down the membranes which line internal organs. These membranes can be discharged from the body, along with the blood. This is almost never survived.

Variola minor occurs in 2 forms. The first is true variola minor, a milder virus & has a low rate of complications & only about a 1% death rate. Few pox appear. People previously vaccinated may also have a 'minor' manifestation of smallpox & have a good recovery rate. It's important to remember that both manifestations of variola minor ARE contagious & the type associated with immune response from a vaccine can STILL lead to full blown cases in other people. Variola minor can sometimes be mistaken for milder pox type diseases, such as chicken pox.

So what happens to infected patients? What symptoms do they get & in what order? At what point can they infect others?

INCUBATION PERIOD:

A person has contacted the variola virus. In this period, the virus is replicating, (making many more virus particles), within the body. People have no symptoms & usually feel perfectly fine. They are NOT contagious. This period has an average duration of 12-14 days, but can range from 7 to 17 days.

OF A VIRUS HAS BEEN BIOENGINEERED, THE INCUBATION PERIOD MAY CHNAGE. It may be shorter. As well, persons MAY be contagious before they feel too badly. We simply don't know this.

FIRST SYMPTOMS:

The first symptoms include fever, head & body aches, feeling unwell & sometimes vomiting. The fever is fairly high, usually ranging from 101 to 104 degrees, (38 to 40 degrees Celcius for metric fans). People by now usually feel too sick to carry on as usual. This phase lasts 2-4 days. Patients are not stated to be infectious during this phase. It is POSSIBLE they may be, especially in the few hours before they break in pox.

DAYS ONE TO FOUR OF RASH:

Here's where it gets tricky. The FIRST place the rash breaks out is on the tongue & in the mouth. These spots rapidly develop into sores which break open & spread large amounts of virus into the mouth & throat. The patient is now at his/her MOST contagious. Persons caring for someone sick, may think they have flu, a bad cold or something more run of the mill. Meanwhile, the patient is coughing, perhaps sneezing & spreading variola virus throughout the room.

Within 24 hours, a rash breaks out on the skin. It starts on the FACE & rapidly spreads to the arms & legs, then hands & feet. As the rash comes out, the fever drops & patients actually feel better.

By day 3, the rash MAY be all over the body, save for the palms of the hands & sould of the feet & it looks like raised, red bumps.

By the fourth day, the bumps fill with a thick, cloudy fluid & sometimes have a 'dimple' in the middle, making the bumps look like belly buttons. This is a MAJOR red flag that this is smallpox. At this point, fever often rises again & remains until the pox scab over.

DAYS FIVE TO TEN

Over this time period, the bumps become pustules, sharply raised & feeling 'grainy', as if there was a beebee under the skin.

DAYS ELEVEN TO FIFTEEN

The pustules begin to crust over, eventually forming scabs. By the 14th day, the sores are usually mostly scabbed over.

DAYS FIFTEEN TO TWENTY ONE

The scabs begin to fall off, leaving marks on the skin that become pitted scars. The pox usually occur over hair follicles & sebaceous glands, (where sweat & skin oil comes from), which explains the deep pitting. The person remains contagious to others until ALL scabs have fallen off.

AFTER DAY TWENTY ONE

The person is recovering & is no longer contagious.

Bear in mind these timelines are 'flexible', Your patient may go through these stages more quickly or more slowly. Serious manifestations & life threatening complications will most likely occur fairly early in the course of the disease, although later on, secondary infections, especially of the skin pose a serious threat.

CanadaSue · #14 10-07-2002, 10:59 AM

So how would we know if a smallpox attack has been launched in the US? Let's assume some unknown people; terrorists or government operatives from a foreign ogvernment recieve orders to 'deploy' smallpox. If their intent is to spread this as widely as they can in as short a time period as possible, it's not too complicated. If a single case would create a national emergency, imagine what cases in a wide variety of locations would do? The nation would quickly end up paralysed in a number of significant areas; economic, health, military, infrastructure, food & supply distribution; all these things could be severely impacted.

Before we know what's going on, a case has to present itself to some medical facility, be recognized for what it is & the appropriate notification procedures initiated. Here's a likely scenario. A person goes through the initial period of symptoms; figures she just has a bad case of flu. This may be occuring among 100 or so people in various cities. The operatives would perhaps have chosen to release the virus in busy hub airports, popular indoor tourist attractions, conventions, shopping centers, sports events...

After a few days, the sick folks &/or their families become concerned. This may start looking anything like run of the mill colds, flu, etc. If anyone infected in the first wave has pre-existing conditions, the sickness may progress quickly enough to send them to hospital sooner, rather than later.

Okay, they make it to hospital. Unless they've broken in mouth sores or blatant pox, hospital staff may conclude they're just suffering from a nasty cold or early flu & send them home with instructions to rest, drink fluids, treat fever, etc. Now, if several patients present at the same hospitasl within a few hours, that will raise some red flags, especially if flu season hasn't started yet. They may still be sent home, but be told to immediately contact hospital if things get worse.

At some point, someone will show up at hospital with frank symptoms of smallpox & be tentatively diagnosed as such. Local/state & federal authorities will be contacted & the patient, pending confirmation by the CDC or a well equipped big city hospital will be isolated. As well as being trated as best they can be, the patient(s) will be questioned as to their basic state of health, when they got sick, where they were, who they've been in contact with, especially since they started feeling really badly; all the questions an epidemiologiust is likely to ask.

The CDC will send an investigational team immediately to each location initially reporting suspected smallpox cases. It may happen that several cities report such suspicions within a few hours of each other. CDC would also be holding some quick & dirty emergency meetings. They would involve USAMRIID & you can bet the President would be informed as soon as possible; he'd need to be warned.

Emergency notifications would be e mailed, faxed, phoned, etc. to as many medical facilities as possible, indicating that a smallpox outbreak MIGHT be developing & reminding hospitals of symptoms to look for & how to isolate/treat patients. All in all there would be a flurry of activty at all levels - hard to predict what would happen in exactly what order at what speed.

Fairly soon, this breaks in the public. Either an official announcment is made or a hospital staff member phones friends/family to warn them. Then the jungle telegraph takes over. So when do YOU get concerned? If you hear it 'officially', time to be prepared to batten down the hatches. If you hear from friends, especially those working at hospitals who have suspected cases, it's up to you to determine the validity of that warning.

In any case, at some point you decide this is credible, that the US has likely been attacked using smallpox. You have already determined you will take your chances at home. You're prepared to wait it out, the crisis that is; at home & are prepared to care for anyone in your family who gets sick - at home.

You've obtained all the equipment you can that you think you're likely to need. You have a good idea of your own & your family's strengths & weaknesses. You have the knowledge you need, either in your head, in books you've obtained or material you've printed off the net.

Make SURE you have the emotional toughness you may need. If you have decided to tough out this emergency at home, you're probably prepped to last a long time in terms of supplies etc. Are you ready to deal with neighbours/family/friends calling you or knocking at the door pleading for shelter & your help? Are you tough enough to keep the door closed, not knowing who may already be infectedd & possibly contagious? Can you 'lie low'? Does your family have a way to get home fast & in a quiet fashion? Do they understand that during an emergency, the normal rules don't apply; that some things may have to change drastically? Make sure you have all these things thought through. Even if you're not sure how you will respond, think it through. It's better to know what you don't know, or what you're not prepared to deal with from the gitgo. Someone in the family may be better than you at firmly refusing entry to others, to dealing with phone calls. It may be best NOT to answer the hpone, ,unless you have call display.

Okay, you're there. This is as real as it gets. Let's start with what you first need to run a sick room..

Loretta Van Riet · #15 10-07-2002, 01:16 PM

bump!

Rizzo gal · #16 10-07-2002, 07:43 PM

Bump.........Need to keep on front page!!!

CanadaSue · #17 10-07-2002, 08:00 PM

If you're going to look after a family member/other loved with smallpox at home, you first need to examine your home & find the best room in it possible to care for that person. Often families got by in 12 x 12 cabins. That's a little tight for my liking, but most of us can do considerably better than that today. We also have running water, (usually) & toilets. Remember, in the "olden days", families managed to go about their daily business & still care for the seriously ill with no special provisions, no isolated rooms & little or no access to information

You can too. Don't let poverty or small, cramped quarters scare you off if you truly feel your family's best interests are served by staying in your own home. You don't have to have anything close to "perfect" locations or 'ideal' circumstances.

Do you have a room, be it a bedroom, den or other room that you could, in a hurry, clear out for your patient(s)? It only really has to be big enoough for a bed or mattress, a small table or 2, a chair of some kind for you & hopefully have an electrical outlet for lighting. If you are sharing a small bachelor apartment with someone, do you have a corner or end of the room you could quickly clear out if your loved one got sick? If you have either of these available to you, you're all set.

Your main consideration is keeping the variola virus "in there" & everything else not related to care "out there". In other words, you don't want to spread the virus to others in the family. Secondary cases among household members of a smallpox victim being cared for at home range frrom 30-65% & that is usually dependant on how you can manage. Households that crowded where such stats were gathered, often were impoverished & had no way of trying to keep patients isolated. They often couldn't even round up clean water & soap. We can, so I think the seecondary infection stats CAN be quite a bit lower than that.

Variola virus can live for a time on 'things' in the room & around the patient. Smallpox ridden blankets were given to native North Americans, the first biowarfare here in North America. It worked. Mail & baggage has been known to sicken people up to a week or 2 AFTER such items have left the vicinity of a person sick with smallpox.

This means you as caregiver are going to have to be careful how you handle laundry, dishes & other objects in the room. A lot of these concerns can be prevented by what you do to a room BEFORE your patient enters it.

Here is what you want to look for in the 'ideal' room, or the best one possible. Preferably, it is painted with semigloss or other washable paint. If it has wallpaper, that wallpaper is NOT textured. If your ideal room otherwise has textured wallpaper, don't sweat it. There are ways to clean that too & if you ruin the paper while caring for a smallpox victim, all in a good cause. You want as few openings into the room as possible; preferably just a door & perhaps a window. Electrical outlets, heating outlets or ventilation outlets should be sealable or easy to spray with cleaner while you're using the room as a 'hospital room. You want flooring you can wash. If the room is carpeted, how fast can you strip out the carpet or area rugs? If you can, great. If you can't do it easily, find another room or steel yourself to ripping it up anyway, WHEN YOU NEED TO. If you're working in a basement room & are dealing with unsealed concrete, no big worries, that can be cleaned too.

If you're going to use this room, when you do need it, you need to remove the following: everything except what you absolutely need. Curtains come down as do curtain rods & such fixtures. A basic blind is best - easier to clean & keeps out light. Anything on the walls, photos, kids drawings & other art, posters, everything. Yeah, you need a time piece, but a small alarm clock in a Ziplock bag is much easier to keep virus free. Examine any openings into the room, outlets of various sorts, vents etc. Can they be sealed with duct tape or electrical tape? Being able to do so will make it a whole lot easier to keep virus IN the room & away from everyone/everything else.

If you need to use the end or corner of a room, you can partition it off with a large sheet of heavy duty polyethylene or some kind of plastic. Pre-measure & buy some as well as LOTS of duct/electrical tape to seal off your space, allowing room for a flap for an entrance of course. Pick up enough of this sort of plastic sheeting for several complete walls, (stuff happens) & enough for patches should you accidently pierce through your 'wall'. Okay, so you may have to get clear plastic which kills privacy, but I assure you, this will not be the major concern for you or your patient.

It's handy if your chosen room is close to a bathroom. An ensuite is perfect, but not necessary, just really handy. Nearby laundry facilities are great. In an apartment & have to use common facilities? That can be done without endangering others as well.

A closet in the room is handy but in the absence of one, several plastic bins can serve the same purpose & can be stored under a table. It helps if they're covered, although that's not entirely necessary & being plastic, they're easier to keep virus free.

Now how do you need to furnish the room? Remember, the idea is to simplify your life as caretaker. You want those furnishings you need to care for your patient & you need them easy to keep clean. You don't want so many items in there that you start tripping over things or have to waste a lot of time keeping things virus free.

First thing you need is a bed. Keep it simple. If your back & knees, not to mention hips, are up to it, try putting a mattress right on the floor. IF you can, place it on a sheet of plastic, you may have body discharges to deal with that are easier to clean off plastic than the floor. Put the bed as far from the room door as possible. The farther the virus has to travel to infect anyone else, the better. Don't, if possible put it right up against the walls. You may need to access your patient from both sides of the bed.

Next you need a table to put your basic nursing supplies on. If the room is big enough & you have them, 2 tables might be preferable. One near the patient's bed & one near the door for other supplies which may come in handy. If you can only manage one, go for a larger one which you'll keep close to the door. These don't need to be special in any way, except easy to clean. Plastic tables, the kind you use on patios & decks are perfect. They clean easily.

You'll want a decent lamp, not decent as in good quality, but decent as in offering good lighting. Cheap is probably good; or one you don't mind disposing of after your patient(s) heal(s). A cheap flashlight near the patient's bed is good too. If you don't have a small table near the bed, hammer a nail into the wall within your easy reach & hang the flashlight there.

You'll probably want a chair in the room too, for you to rest in. Again a plastic deck chair is perfect, as long as you can be comfy in it. Put a cheap pillow on it or something to give your butt some comfort. Pillows wash & so do plastic chairs.

Now furniture doesn't have to be plastic. I'm simply trying to point out that plastic or other simply built & easily cleaned furniture makes the care taker's life easier in terms of cleaning effort & reduces the risk of spreading the virus.

When you're standing in the room you plan to use, visualize where you might put things. Determine where you're going to place things you're removing & from where will come what you ARE using in the room. Move through the room. Walk in as if you were coming in to take care of someone. Is the bed placed in a reasonable location? Does your table placement make it easy to get things? How about your chair; can you easily see your loved one from there? Littel things perhaps, but every step saved saves you energy.

Next, 'soft' furnishings & linens.

Sorry, folks... I meant to be working on this faster, ,but DH is not well, ,SD is needing a lot fo help with school & SO MUCH IS GOING ON. Trying to keep up with it all is driving me nuts. I nned to pull an all nighter one of these days, but probably not tonight. I be wiped. I'll try to get the next part posted in early am. Setting the alarm for 0500; gives me 2 hours before everybody wakes up "needing" me...lol

driveshesaid · #18 10-08-2002, 02:29 AM

BTTT.

This is important stuff folks. Let's keep it on the front page 'till Canada Sue is finished.

drive

driveshesaid · #19 10-08-2002, 02:31 AM

Holy cow! I just became a senior member! Never thought that would happen. Guess I'm a bigger motormouth than I thought!

drive

CanadaSue · #20 10-08-2002, 07:10 AM

Now that we have the 'big' furniture looked after, let's look at the smaller stuff as well as the linen you're going to need. Before I explain why you need something, I'll simply make a list. If the list seems rather small, I'm assuming many are simply not in a position to obtain extras. Money is tight for many of us & 'fancy" doesn't mean better in many cases. While having the luxury of dedicating 10 sets of sheets to the sickroom is nice & cuts down on how often you have to do laundry, it's not necessary. The same applies to everything I list here. This list covers only equipment & linen, though for anyone wanting a quick & dirty inclusive list, I'll reiterate the furniture. Medications, cleaners & disinfectants will be covered shortly.

I plain bed or mattress

1 plain table

1 lamp

1 flashlight

Batteries

Clock

Ziplock or other sealable plastic bags

Plastic dishes

Utensils

Plastic

Duct/electrical tape

Medical face masks

Rubber gloves

Fabric gowns or cheap plastic raincoats

Plastic garbage bags

2 wash basins

bedpan

Urinal

3 sets of sheets

2 blankets

1/2 dozen washcloths

2 bath towels

2 hand towels

4 plastic/metal 10 gallon buckets with lids if possible

2 magic markers

Couple of pens/pencils

Paper

Printed info on smallpox symptoms & progression

Clipboard or hard surface to write on

Rubber boot tray with lip

Air fresheners

1/2 dozen plastic spray bottles

Remember, this is a minimal list. Many of us can think of more things to add that we have available or can easily obtain. These items would include convenience items, comfort items, etc. I'mm mention some of these as I go. None of them are absolutely necessary & some of the things in my list here can be substituted for to save money or replace something you don't have & simply can't get. I'll mention those & suggested substitutions.

Many of us don't have the luxury of setting up much of this in advance of need. That's fine. You'll surprise yourself with how fast you can get a room ready for a sick person; how quickly you can put together everything you need in a pinch. If that means you rifle through kitchen/bathroom cupbioards & leave a bit of a mess behind you, so what? Gives other family members something to do instead of wringing their hands & if it's just you; well your patient will not need you there 100% of the time.

Next list: cleaning supplies & 'medical' equipment. That will be followed by a suggestion of how to organize everything, how to set up the room & care areas you'll be using - including bathroom/laundry facilities. Then we'll get into care - step by step, stage by stage.

Brooks · #21 10-08-2002, 08:15 AM

Sue, thank you so much.

Since it is on my mind and you are gearing up to this next phase... How about prestuffing a whole bunch of trash bags into the barrels so all you have to do is peel them off when they are full? It would mean less handling of the bags once things got dicey and create a little less breeze as the bags are being inserted.

Also, there are heavy plastic covers for different size mattresses, some of which completely enclose the mattress with a zipper. I have used them for my incontinent parents. They're fairly cheap so could always be tossed at the end. It would ensure the mattress survived. Similarly, if a bed support is used, maybe plastic sheeting could be draped between the box spring and the mattress and down to the floor.

Also, large bed pads are much easier to wash and replace (if the patient doesn't feel like moving) than stripping bed sheets repeatedly.

I'm a little worried about heat with your scenario for those of us with forced hot air. Closing off the vents will really cool the room down in the winter. It might call for an alternate supply of heat, like an electric heater.

CanadaSue · #22 10-08-2002, 08:42 AM

Yeah, when I start blithering on about "how tos" & "oh by the ways", I'll be talking about that kind of stuff. Being a slack & idle individual by nature myself, I'm always looking for ways to save effort. Nursing the very ill; everything that saves as little as 10 seconds of effort is helpful.

Back from a night at hospital, DH not well. Bear with me, brain only working at 3/4 speed today.

Brooks · #23 10-08-2002, 08:59 AM

As much as 3/4 speed?

That was the other thing I learned, doing intensive hospice for Dad for his last few months. Effect of extended, extreme sleep deprivation. Brain, what was left of it, on automatic. Ability to reason out the door. That certainly speaks to needing more than one person for this type of nursing. If not, it becomes all that much more important to have a plan and supplies ahead of time.

Hope your DH is doing better Real Soon.

CanadaSue · #24 10-08-2002, 09:43 AM

You now have a list of furniture & household equipment required/desired to care for your sick person at home. There's a bit of overlap as some of the stuff in the 'room list' could be called medical equipment but no matter. At the end of this, as appendices, I'll redo the lists & various other lists & tables. I'm sorry I'm not more computer literate. If I were, I'd be able to do fancy tables & stuff, but I'm not & would rather get this info out as soon as possible.

Now, what about medical equipment & cleaning supplies, both to clean the patient, yourself, laundry & items in the room?

Here we go:

Patient thermometer

2 dozen wire hangers

Pliers/wire cutters

2 gallons of bleach

Concentrated cleaning solution

Hand soap

Soft cloth or sterile gauze pads

Blanket, (for caregiver)

Cheap paperback, (for caregiver)

Loose gowns/nighties, (patient)

Comfy clothing (caregiver)

Socks/slippers, (caregiver)

Small, cheap radio, cassette player

Small fan

Extension cord

This is far from an exhaustive list & most, especially those with experience caring for the ill, will easily & quickly think of additions which will make life easier for both yourself & your patients. As long as these items can stay in the room or care area & are easy to clean; why not?

Next: setting up the room & preparing for care.

CanadaSue · #25 10-08-2002, 12:06 PM

Supper is done & the kitchen is clean. Hubby is out trying to find the cat & your daughter is yapping on the phone. Your son is destroying scads of aliens on some computer game. You're sitting in the living room sipping on a cup of tea, feet up on the ottoman & smugly grateful you did the groceries early this morning. It's Thursday & other than catching up on laundry, your housework is done for the week. Your daughter has gymnastics practice Saturday morning, but hubby already promised he'd take her. Yous son has a birthday party tomorrow night & you've bought & wrapped the present. You're a bit tired & after the news & catching a bit of TV, you figure you'll take a hot bath. You have that new Jean Auel novel you're dying to get into.

News starts, same old stuff for the first few minutes. A local factory announcing layoffs. Work scheduled to start this spring on traffic lights at 2 busy intersections... you go to the bathroom after the weather, while an annoying ad for a second had car lot comes on.

Instead of the usual community information after the ad, the newsie goes straight into a story you hadn't expected. A 14 year old girl has been admitted to University Medical Center with a 'strange' illness. She's been sick for several days, has been at home with what her parents thought was an early case of flu. After all, flu hit your community early this year & flu vaccine isn't available yet unless you are resident in a nursing home. This girl has now broken out in a rash over most of her body & has been placed in isolation.

The newscaster goes on to add the illness is 'causing conern' among medical staff at the hospital. The young lady has been placed in isolation & 2 members of her family, also with fever & bad headaches, hae been admitted as a precaution & placed in isolation. Furthermore, several patients are being evaluated in emergency with similar symptoms. The hospital has contacted the state Public health Department who is sending down a small team of specialists to evaluate the girl's conditon, as well as that of those family members who also seem to be ill.

A statement from the Chief of Medecine follows. She states that it's unusual for several members of a family to be stricken with flu at the same time to this degree. This illness has as symptoms; severe headache & a fever of over 101. While only the girl is showing a rash, the hospital is concerned for the whole family at this point. The girl is a tenth grade student at Middle Hills High School & the hospital staff is currently checking to see if any other students have been absent with similar symptoms or, seen by teachers as not feeling well.

The girl's younger brother, also ill, attends seventh graded at RF Kennedy Middle school. Mother works part time as a cashier at Safeway at the Middle Hills Shopping Center. The principal of the middle school & employee director of the safeway's are being contacted to see how many staff or pupils may also be ill.

While it's too early to determine the nature of the illness, it's possible it may be environmental or an infectious illness. If it IS the flu, it's unusual in that most patients with flu so far have had strains which are not known to cause severe illness in most.

Anyone suffering from cold or flu symptoms with a severe headache, severe body aches or a high fever are asked to contact their doctor, local clinic or the hospital. There is no need for most to worry but those who are immune suppresseed or have existing serious medical conditions should avoid crowds. No questions are taken & the newscaster goes on to cover several other more mundane stories.

You turn down the volume on the TV & wonder if a nastier strain of flu has hit town. You hope everybody stays well this year. You also wonder & worry about your own children. Your daughter is in the same grade as the unidentified, sick girl & while your son is in eighth grade he does attend the same school as the sick boy. You haven't shoppeed at Safeways recently. While you're pondering, your dughter walks in & asks if she's ever had measles vaccine? Puzzled at the question, you answer in the affirmative & ask why? She mentions Elaine from her English & History calsses has been away all week with what she thought was flu. Your daughter stopped in to see her for a short time after school(!), & Elaine was 'freaking out' over these weird sores in her mouth - your daughter describes them as "cold sores gone nuts". She repeats that she didn't stay long. Elaine felt crappy, her brother was sick & her mother didn't look so hot either. Anyway, she was just talking to a mutual friend who mentioned she thought Elaine's dad had driven her to the doctor's to be checked out shortly before supper.

Your blood runs cold as your daughter wanders back to her room. Elaine is sick. Her brother & mother are also sick. Dad drove at least Elaine in to be checked out by a doctor. The hospitalized girl & her sick relatives sound a LOT like what your daughter just told you. You sit a few minutes more, your pulse racing as you try to slow down your thoughts.

You 'casually' walk to your daughter's room & ask her; other than the mouth sores, how did Elaine look? 'Lousy', your daughter answers. She was pale, very tired & said she was really hot. Your daughter only dropped in to give her some hisotry notes before a test coming up next Wednesday. Elaine was coughing a fair bit & because of that & the fact that she was so unwell, your daughter left after 20-30 minutes. How does SHE feel? Fine; why? You shrug & mention that flu IS making the rounds; you're just making sure she's okay. You ask, offhand, if she knows the brother's name. Greg, she replies & gives you the last name of the family, puzzled. You explain you wondered if he was in your son Andy's class. She reminds you they're in different grades, then rolls her eyes & pointedly reminds you she has a science test to study for. You leave her to her work, heading for the family room where your son is still zapping aliens.

Yes, he knows Greg, often hangs around with him at lunch. He hasn't been at school since Tuesday though - lucky guy! Andy feels fine, just a bit tired, why? You make some excuse, then go to the kitchen to make more tea. Your husband comes in, struggling with a squirming cat & trying to suck the blood off his thumb where the cat scratched him. Vermin did NOT want to come in yet. Quietly & quickly, you explain what you've heard & what the kids have told you. Your husband is also worried. Since the initial warnings of a possible bioterror threat against the US, you've both taken such reports seriously & have read as much as you can about the diseases that could be used.

But what to do? You don't after all, know very much yet do you? A classmate of your daughter's is sick. She's been home for 4 days with what was thought to be flu. Her dad took her to her doctor's to be checked out late this afternoon & now she's been hospitalized; you think. Her mother & brother have as well, ,as a 'precautionary' measure... for what? The Chief of Medecine views it seriously enough to have made a statement to a local reporter, urging those with certain symptoms to call their doctor. Your daughter visited the gil, who had mouth sores & a cough. The hsoptial reports she now has a widespread "rash".

Your husband calls a hunting buddy, who works as a lab technician at the hospital. He's off today, but might have some info. Your husband hangs up & looks at you, even more worry appearing in his eyes. His friend was calleed in to work about an hour ago? You try a friend of yours, who works as a receptionist in emergency. No, she tells you, she doesn't know what's going on but has been asked to work a 12 hour shift tomorrow instead of her usual 8. Inconvenient, but there you go; it happens.

Now you & hubby are really concerned. He has a bright idea. You get your gloves & coats & tell the kids you're just stopping in at the grocery store; your friend told you of a great spot sale on toilet paper. Your daughter snickers - you have a closet full of the stuff already! You drive towards the hospital & as you approach, you slow down. A lot of cars in the emergency room parking lot & a number of people helping others walk to the emerg entrance. You pull over across the street & quietly observe. In the 10 minutes you sit there, ,3 ambulances come in & 2 others go out, at speed. Not typical for a quiet, late fall, Thursday in your small city; especially this part of the city. More & more poeple arrive to emerg, some on foot, most by car. You see people coughing & many appear to be having difficulty walking. You & hubby look at each other alarmed. Doesn't this sort of thing fit the possible scenarios you've heard about & read over? Without a word, you head for home, both of you thinking furiously.

Once back in the kitchen, you let the kids know you're home, then sit & talk. You have the radio on in the background & hear no mention of a major fire, traffic accidents or the usual things which would fill emergency quickly. You hubby's friend was called in & yours will work an extra half shift tomorrow.

Your hospital normally does NOT make such statements, even about flu, not this quickly anyway. You both come to the same conclusion. Something major is happening & neither of you are willing to take chances with your familiy's health. You're already terrified for your daughter's sake. She may have had a major exposure to an infectious illness; you don't even want to THINK about the outcome of that. But you must &... you do.

So, you & hubby will spend the evening preparing for 'the worst'. You're both preppers & are adequately stocked. Nevertheless, at around 3 am, your husband will go to the 24 hour grocery store & if necessary, use the VISA card to buy more of the supplies you're likely to need if this is a bioattack, if your family IS directly affected.

You will help him make that list while you clear out the sewing room to use as a sick room. As much as you hope not to have to use it, you'd rather be prepared. But now, it's time for both of you to have a cup of tea, catch your breath, then talk to the kids.

Nope, this certainly doesn't fit every family scenario. But I work better with an image 'in my head', (it's chamomile tea by the way & the cat is a greedy, spoiled, orange monster), & the advice part that comes next is generic. Adapt it to your chosen room or location & bear in mind that my prepper couple is not perfect. They're going to make a few mistakes buying things & will later have to adapt/substitute/make do for various reasons. That will allow for those who simply can't prep as well as others. Remember, while a lot of $$$ is nice a great many of us live cheque to cheque & have to make do with what we have/can beg/roow/scrounge/steal.

Next: telling the family what is what & dealing with whines & complaints, especially from kids. That will be followed by actually setting up the room & other areas needed. This family may have a biggish house but they only have one bathroom. That was hubby's chosen winter home improvement project... LOL.

CanadaSue · #26 10-08-2002, 01:35 PM

Your hubby & you watch the kids return to their rooms, both masking their worry with sulleness. Your conversation with them did not go terribly well. Your daughter is 15, your son 12 & both can be difficult when they choose to do. It seems they're choosing that now. Tough. As you've made clear to them, wether you're right or wrong in your evaluation of the situation, you're not taking chances with their health or yours.

In effect, you've 'grounded' them both. They can no longer leave the house, except to go out in the back yard for a bit of fresh air & these excursions will be limited timewise. No friends come in & not only do your kids not go out to friends' homes, social excursions & school are also going to be missed, at least for a short time until you can determine what exactly is happening. Your daughter could care less about mising some class time, but not seeing her friends? You are both being SO unfair! She was planning to go to the movies tomorrow night after supper; you've completely RUINED her weekend. Your son has informed you that it's HIS life & he WILL go to that birthday party. No... he won't.

In short, the kids think you're crazy. How are they going to explain this to their friends? Your daughter is already on the phone; seems she's trying to explain it as you fume. You remind yourself to start limiting her time on the phone. This is not the time to be tying up the phone lines. You hear your son slam his bedroom door shut & the volume on his radio cranked up. It's on a station you loathe. You'll ignore that for 15 minutes or so then remind him that wether or not he's happy with your decision, YOU are the parents & he will do exactly as he's told - period. And his radio gets confiscated if he doesn't turn it down.

You've tried to explain to the kids the source of your fears. Your daughter kept rolling her eyes as you fought the urge to backhand her one. You get the impression she's not going to co-operate in terms of doing more housework as you try to prepare. She's not too old to be sent to her room or otherwise punished if she doesn't get her fit of sulleness out of her system - fast. Your son kept whistling & turning his head until your husband was forced to not too gently grab his head & turn it until he was facing you. A few tears, some snivelling, but he at least looked like he might be listening - until you got to the paret about the party.

It looks like you're going to have to sit them down again & explain things to them. If necessary, you can read the riot act. Your daughter can be expected to try & force the issue. You'll consider yourself lucky if she attempts to force just one issue. You have told both kids to spend the rest of the evening cleaning their rooms, putting things away, dusting vaccuming & clearing out some closet space & some 'under the bed' space. Clearing out the sewing room means you need some space to put things. The kids rooms are easiest. Tomorrow morning, both kids will get to work. There's laundry to be caught up on & you want to give the bathroom a good scrubbing out. For some reason you'll feel better if you go into this potential crisis with a house scrubbed as clean as you can get it.

Your hubby will call in sick to work & give you a hand. Exactly what he ends up doing will depend on what, if anything you hear on the news. At the very least, he'll replace your front door lock with a deadbolt & replace the door with that solid wood with steel core one that's been sitting in the garage for months.

You finish your umpteenth cup of tea & head to your sewing room. You spend the next hour removing the family photo montages that somehow ended up in there, as well as the quilt you've mounted on the wall. Your extra bolts of fabric & trim is boxed & hubby drags all that to the basement. The sewing machine is packed up & stuffed into your son's closet. You empty the room, dragging the furniture & miscellaneous stuff that's found it's way in there over the years. How did so much junk get into one small room? Impatiently, you put a lot of it out to the curb - tomorrow is garbage day & you don't have time to sort through it. The last item to be dealt with is that old wall to wall carpet you never dealt with. The subfloor is nothing great, but it's solid & looks don't count here & now.

You finally empty out the room & hubby removes the curtain rod. Oops, that pulled out a lot of drywall. Never mind he has some of that junk you use to patch holes somewhere... he can find it while he's looking for the old blind. Meanwhile, you wash the walls with hot water, soap & bleach. Boy, been a while since you seriously scrubbed a wall. You'd forgotten how tiring that can be on the upper arms & shoulders. Hubby finds the wall patching stuff, but where the heck did that blind go? Never mind, later...

He patches the hole he made removing the curtain rod hardware while you look for the old inflatable camping mattresses. You finally find it, but decide setting up the room can wait until tomorrow. You're exhausted & stressed out. You've already gotten into 3 minor spats about his (in)ability to pull out old drapery hardware & he's not thrilled about how much 'sewing junk you've got'. Your daughter is still acting the snot & that's the source of another argument. You're inclined to really ream her out but 'daddy's little girl' might be too upset, so noooooooooooo. Argh!

Maybe it's time for another cup of tea then some sleep before morning. Hubby can go get the extra groceries you need. Yeah 3 am is late to shop, but there's less risk of encountering other shoppers & thus less risk of catching anything they may be incubating. Late local news repeated what was said after supper, but no new details were added other than saying since supper, "many" people had called their doctors or visited clinics to have worrisome symptoms checked out. No news on wether any were hospitalized or what diagnosis any were given.

Been a long day. You're getting more than a bit cranky. You tell the kids good night, then try to get some sleep.

Nothing really happening yet, but already our couple is stressed out. They're concerned about an unknown situation. They have some tantalizing clues there MAY be a serious, indeed grave crisis brewing but really don't have much to go on. They're taking a gamble reacting as they've chosen to. What if they're wrong? They'll look & feel foolish. The kids are not reacting as they would have liked although the reactions are well within the bounds of expected reactions for kids that age.

Their daughter's friend is the suspected case in hospital & they're concerned about her & any exposure their daughter may have had. What about their son; is he also at added risk? And sure they're preppers; but do they have the right stuff? Do they have enough of it?

Uncertainty is a killer. When something serious is brewing, MOST people react better if they have as much information as possible. After all preparing for a 'known', no matter how terrifying is easier than trying to prepare for one of many possible serious contingencies.

I give our couple points for having enough knowledge to realize a crisis may be brewing. Give them points as well for being preppers & having a lot of stock already. Right now, I'd caution them to stop stressing out, as much as possible. Pay attention to the news & other clues. Continue prepping their room. Sit the kids down again & do what you have to do to make them HEAR what you're saying. If you have to shout, thump the table; whatever it takes to get their attention & let them know this is deadly serious. If you're wrong, you have lots of time to apologize in future. If you're right... well you won't have to say: "I told you so".

They should jow concentrate on sleeping as best they can tonight & finish getting squared away tomorrow. If something really is brewing, they can expect more solid info tomorrow & will have a jump on most others.

Brooks · #27 10-08-2002, 01:43 PM

Sue, it has long struck me that one of the great terrors of smallpox in this age will be the disfigurement that the survivors can expect. Teenage children, especially a daughter, could be particularly worried about that. When it becomes known that the problem is smallpox, that might help control traffic flow. That is, if they know before they are infected. IOW, far more than this weekend's socializing at stake.

CanadaSue · #28 10-08-2002, 04:06 PM

Thank you Brooks. I was walking this afternoon trying to think of how to 'convince' this 15 year old to "behave" & take this seriously without mom ending up "slapping her upside the head" lol. Of course, at this age an appeal to vanity works. I'll use that. Now, let's see if it works.

I'm trying to come up with 'solid' stats for the various disfigurements...

**Deena in GA** · #29 10-08-2002, 09:00 PM

Bump - with many, many thanks, CanadaSue, for sharing this important information!

Lei · #30 10-08-2002, 11:28 PM

This is great and I really appreciate all the info ...but...
What happened to the story about Thomas and his
family that you were writing ?? You can't leave us hanging .
What happened ???

CanadaSue · #31 10-09-2002, 06:13 AM

... I'm not going to leave you hanging past today on that. Things got a bit busy here the last few days. Quiet day planned; doing both threads.

CanadaSue · #32 10-09-2002, 08:43 AM

This morning, our family has been waiting for news, hoping they're wrong but planning for their suspicions to be right. While they're waiting, they're getting their sickroom set up. Here's what needs to be done in the room... we'll start as though nothing has been done at all & we have to completely prepare a room from scratch. If you already have most of what you need fairly handy, this shouldn't take more than a few hours at most.

Start by emptying everything out of the room unless the bed you plan to use, table, chair etc., you plan on using is already in there. Everything else - out! Look over the room once it's emptied; forget anything? If it has a closet or 2, make sure you've checked the shelves; all the nooks & crannies. Remove any hardware; stuff you use to hang curtains, plants, anything like that. The variola virus CAN survive on things for a time; you don't want to take that risk. I would remove all curtains too & either replace them with a plastic, easily cleaned blind of another material or, tape up a plastic garbage bag. At some stages of the illness, it may be more comfy for your patient if you can darken the room.

Next clean the room; really clean it. Vaccum if you can, remembering to get cobwebs off the ceilings & anywhere else they're lurking. Get windowsills, the tops of doors too & the tops of any molding you have along the floor. Got overhead lights? You may want to remove those or, if they're the only lighting you have in that room or can put in there, just be aware that dust, dedad flies etc., like to collect in the shades. Clean them before you use them & you'll be keeping them clean while you have a patient using that room.

Right, room is empty & vaccumed or swept. If you've chosen to sweep by the way, spray the end of the broom with Lysol or similar cleaner, even Windex.. it will help the dust bunnies stick & prevent them simply 'changing locations' in the room. The idea is to REMOVE all dust & dirt not simply move it from one corner to another.

Time to wash everything down. Mix up some water, a little bleach & a concentrated cleaner in a spray bottle - much cheaper than using a premixed cleaner you buy. I figure by mixing up my own, I lower the price by about 85%. If you can't wash your ceiling & if it's textured you probably can't, then spray the heck out of it with your mix. Spray until it's darned near dripping. While that's drying, take a break or do something else.

Wash the walls with the same spray. We're not looking for stain/fingerprint removal so much as 'pre-use' disinfection. As long as your mixed cleaner has a 1/2 - 1 teaspoon of bleach, you're killing most bugs in there. Don't forget windowsills, tops of doors, moldings & inside your closets. Finish up by washing the floor. Take a coffee break - you need one by now.

Let's set up the room. In goes the bed or if it's still in there, you move it to where it will best fit. Remember, ideally you'd like to have access to your patient from both sides of the bed. If the bed was still in there or any other furniture while you were cleaning, I hope you covered the furniture with something.. lol. A wet mattress is no fun.

So, do you use a bed or mattress on the floor? That's up to you, but whatever you decide to use, keep it simple for you. A bed frame with all sorts of complex things on it, fancy scroll work, etc. or... God forbid... wicker; is miserable to keep germ free. The simpler the structure of the bed, the easier for you. Not having back or knee problems, I'd choose to use a plain mattress on the floor or an inflatable mattress.If you can't crouch down, kneel down or bend over easily, use what you have & we'll cover keeping stuff clean later...

To keep the mattress as virus free as possible, put a zipup mattress cover on it if you can. If not, you can do much the same thing with plastic, be it heavy duty plastic or in a pinch, ripped open at the seam garbage bags. Make sure the plastic completely covers the top of the mattress, the sides & is tucked in under the edges. Duct tape it on solidly. Incidently before you do this, you might want to vaccum the mattress; dust mites & just plain dust - mattresses accumulate a surprising amount of these.

Table - you're putting a small table in the room to hold supplies you'll frequently need. Again, the simpler the table the better. A cheap plastic table such as what is sold for poolsides, patios, decks & balconies is great. Easy to clean & if you end up havng to dispose of it after a crisis, no biggie. Locate it close enough to the bed to be useful to you, but far enough away so that your patient doesn't accidently knock it over.

On this table you'll want a thermometer. Sit that in a small drinking glass with a bit of disinfectant in it - Listerine is perfect. If you don't have any or want to keep this cheaper, a mix of water & rubbing alcohol, about 4/5 water to 1/5 alcohol will do nicely. Tastes icky, but cuts down the spread of germs. You can use a drop or 2 of bleach instead. Just wave the thermometer in the air a little before popping it into your patient's mouth to evaporate the solution off as much as possible.

You may also want a small lamp on this table or, if you're going with your overhead light, a small flashlight. That lets you check on your patient at night without lighting up the whole room. Hint: when using the flashlight to check your patient, you generally don't have to shine the light right ON the patient. Just shine it on a wall behind or beside them. Usually that gives you enough light to see for your purposes. If the patient is awake, then you can use the light more directly; just warn them in case they want to shut their eyes.

You may also chose to keep a small pitcher of juice or water on this table with a drinking glass. Saves you carrying it over all the time & possibly spilling it. You have better things to do than mop up spilled water.

If you'd prefer not to use a table, a plastic storage bin accomplishes the same thing - whatever you have that will do the job & is easy to keep clean. Just keep it small. Stuff tends to expand to fill the space available & you don't want to be worrying about keeping a ton of stuff clean.

There are 4 other things you might want to keep near the bed - I would. First, a wastepaper basket; obvious reasons. Next, a 'barf bucket'. At the bottom of that, put a small amount of water & bleach mix to help kill virus. A 5 gallon bucket or whatever you can come up with to put in any dirty facecloths, patient clothing, towls etc. Just the small things when you don't want to walk 1/2 way across the room. If it's helpful, label each with a magic marker. A spray bottle of water/bleach mix on or by the bedside table is also handy. Again, it saves steps.

Now a chair for you, the caregiver, is essential. There is nothing virtuous about being on your feet all the time. Anything you can do sitting down, DO SITTING DOWN! If you're the only caregiver, you need to ration your strength. Even if you're not, why wear yourself out? Again, keep the chair simple & easy to clean. If it's not terribly comfy, put a pillow or cushion on the chair. Ideally, you pop it in a plastic bag which you can seal - good old duct tape again. Pop a pillow case or something over it.

You want a timepiece in the room. I'd use a windup clock or small digital clock; just as long as you know what time it is. Put it in a Ziploc; you can see through it to tell time & it wipes clean easily without getting ruined. You don't want to wearing a watch, jewelry or anything like that so as not to scratch your patient & again, to reduce the chances of germs leaving the room if & when you do.

A cheap notebook or clipboard with paper & pen/pencil to keep track of your loved one's symptoms, what treatment you give, if any is useful. You CAN & may forget what you did when. If you've given anyone any sort of medication, especially a child, you're safer knowing when they had their last dose AND how they responded to it.

You might want these last things I've mentioned on a table or in a bin near YOUR chair. They're more for your use than your patients. In this bin or this second, (larger), table, you'll also want to keep extra bedding; sheets & pillowcases. It's also a good spot to keep towels, facecloths & whatever your patient is wearing, if anything. This is also a good spot for any other supplies you've decided make your life easier in caring for your patient. If you keep your facemasks here, make SURE they're in a sealed, smaller container. You don't want them full of virus before you even put them on. You can't completely eliminate your exposure to virus, but can sure limit it. It;s not the best place for masks & gloves, but a few spares kept here is not a bad idea.

I'll end this now, there's a lot more to cover about what you want in the room, but I don't want these segments too long. Next, I'll talk about linens, how you make the bed, explaining that in terms of what we know about the virus, patient symptoms & sources of discomfort etc.

I haven't forgotten those who may not have a room available, who may simply have to section off part tof an existing room. I'll cover that too as well as how to deal with laundry, dishes, food & feeding your patient & care.

Others in the family can do a lot to make your life easier without ever getting near the patient. I have suggestions there too. Let me get back to it...

CanadaSue · #33 10-09-2002, 09:37 AM

This may sound like of lot of preparation & equipment to gather up, but it really isn't. It appears that way when we're not used to caring for people but when it's all gathered together & set up, it's not as overwhelming as it appears. Much of it this preparation too, can be done AFTER you identify a sick person who needs care. Remember, most will feel lousy & need to be 'isolated' as quickly as possible, but you can get them into the care room/area & they can lie down & rest while you whip around preparing things.

Don't have time to wash walls, dust, sweep, etc. BEFORE your sick person gets sick? Anything that really needs doing can be done in the early hours of sickness. If you can't do the sweeping or scrubbing at all for any number of reasons, you can work around that too. I'll cover that in 'ongoing' cleaning. And if YOU are the sick one & live alone, that's the least of your concerns & you're not putting anyone else at risk with your dust & such anyway.

And not to worry, I haven't forgotten "patient waste", urine & feces or vomit you'll have to deal with. Again one thing at a time.

Remember the plastic buckets I mentioned? Here's where they are set up, how & why. You'll want one for patient laundry, all linens & clothing. Fill it partway full of water with a 1/4 cup of bleach. Put a lid on it to prevent spills & label it LAUNDRY. Leave it near the door, out of 'tripping' range. Prepare another bucket identically & label that one DISHES. This is where patient dishes & utensils will be placed. A third bucket with about 3 inches of water; same amount of bleach - label simply TOILET. That should be self explanatory. It can handle anything a patient barfs up too. If you can use a few more pails, they can be smaller for your laundry & dishes. Keep a spray bottle of water/bleach nearby. Once you put laundry/dishes/human waste in the appropriate buckets & put the lid back on, spray them with the mixture. You can let that air dry, but keep a small towel nearby to wipe up an dangerous excess that could send you flying. Just inside the door, place a rubber boot mat, one with a small lip. In it, place a small amount of water with a bit of bleach mixed in, a couple of tablespoons. You want enough of this mix to cover the soles of whatever footwear you have on. You can 'step out of your shoes', (undo laces first), & step right out of the room. If you need to keep them on for whatever reason, at least you've killed most virus on them.

If your patient is using a urinal or bedpan - we don't all have available rooms with ensuites(!), you may want them somewhere along a wall, not too close to your chair but not too far to reach easily. Once used, you empty them into the 'slop' bucket & can rinse them with a water/bleach mix which also gets dumped into the slop bucket.

Why all the special buckets, bleach mix, etc.? The variola, (smallpox), virus IS killed by bleach. Laundry & dishes placed in a bleach solution BEFORE being removedd from the room would have virus & any other nasties on them killed. That prevents as much virus as possible from leaving the room & reduces the risk of you the caregiver & other members of the family contracting the illness.

Anytime you deal with laundry, dishes, sewage or the patient herself, you're going to want to have gloves on. They don't have to constantly be changed. If possible, keep washing your hands with your gloves on & only change them if they develop a leak or you really feel you have to.

To be extra safe, anyone outside the care area who is helping you deal with laundry, dishes etc., should also wear gloves & a mask & be very careful not to 'slop' water around.

Now just outside the room or care area, you'll want to have some extra clothing for yourself. You want something comfy to walk around in & work in. That might be sweats, stretchy pants & tee shirts. As long as it's easy to wear & launder, it works. You'll also want to keep some sort of gowns or cheap plastic raincoats out there. You want them clean & virus free when you're changing after showering or whatever way you're looking after your own hygiene.

You'll want hairnets or shower caps too if you're hair is anything but short. They're not a bad idea anyway, to keep virus out of your hair & off the patient. This is also a good place to keep quick snacks for yourself if you don't have time at any given point for proper meals. Remember, anything IN the room should be considered "unclean", anything outside should be as clean as possible.

Even if you have the luxury of having an 'anteroom' or isolated area outside the care room to keep extra things, make your other family members understand that they should NOT go there unless it's necessary. You might try setting up a schedule of some sort, where someone checks every few hours for laundry or dishes or sewage. Keep this stuff in the care room until just before your scheduled assistant comes & gets it. Then, before it leaves the room, spray the outsides of every container with bleach & water. As you're masked, gloved & gowned assistant approaches, they too should spray ahead of themselves. Every dead virus is a non-infective virus.

If you're the only one in the place caring for a loved one, if there are only 2 of you anyway, it's no problem to take things out & clean them when you're ready to do so. It becomes more a matter of scheduling things for yourself so you save yourself time & steps. We'll do that step by stap after we have a "patient" installed in the room.

For those who don't have a separate room, clear out the end of the room or corner where you'll be caring for your loved one. Under these circumstances, it's likely it's just the 2 of you. As long as you can keep a part of the room clean for YOUR comfort, you don't have to get too obssessive about keeping everything virus free. It's impossible anyway; you're simply trying to reduce the number of virus floating around. Remember, not everyone in the house, even when you can't make special provisions, is going to catch the virus from a sick family member. Anything you can do reduces the risk of it spreading within the house.

You're going for the best you can manage, not perfection.

You've cleared the corner for your loved one. Take your plastic sheeting & duct tape to the ceiling. You can't be too careful here. You want to try & seal any openings between the top of your plastic sheet & the ceiling. Do the same thing to walls abutting your plastic sheet, as well as the floor. Tape that sucker down! Cut away any excess plastic & cut a "door" for yourself to get through. That will leave a flap for you to get in & out through. On both sides of the flap, you want to place spray bottles with a mixture of water & bleach; 2 teaspoons or so per bottle of water. That's a bit strojng, but better a bit too strong than not enough.

Just beforfe you leave the patient area, hold still; stop moving for a minutes. Spray the door area, yourself & anything you're holding. Wait again for a bit to let anything you sprayed sink to the floor. Don't forget to spray your shoes. Slowly & deliberately move through the opening. Slowely so as not to 'stir up' too much. On the other sidee of the flap, make sure the flap is back in place & again, hold still a minute. Take your OUTSIDE spray bottle & spray the flap & the air around you. Hold still again. Then slowly & calmly move away frrom the area. The holding still, spraying & holding still again allows virus to settle, especially after you spray & lessens the risk of virus particles floating through the air. If anyone else is in the apartment or house, it's helpful to keep them as far away as possible frrom the openings into the pateint care area. Virus particles in droplets CAN move up to 10 feet before settling to the ground, less if there's little or no air movement.

Kasota · #34 10-09-2002, 10:09 AM

If using plastic to block off an area, instead of just cutting a door...how about actually overlapping two pieces of plastic to make an overlapped area you can still get through? smaller 'tags' of duct tape could be used to hold the overlapped flaps together during the times you are not actually going through.

I know CS mentioned a fan...if there is a fan going in the room it would tend to make the plastic doorway come open ... and some overlap and tape 'tags' could lessen that effect.

I have an area of my 1800 square foot basement blocked off for worms...small heater with fan in the room used to push the plastic cut out door out...til I overlapped and used tap tags....so I thought I would add my two cents on this one.

John H · #35 10-09-2002, 10:44 AM

CanadaSue,

Just a small point.

If you spray many stipple ceilings with anything containing water, the surface will crack badly and also bits of stipple will continue to fall before and after it dries.

This comes from a personal experience of trying to paint a stipple ceiling with latex paint.

Some stipples may be different.

John

CanadaSue · #36 10-09-2002, 12:06 PM

John, I loathe these dumb textured ceilings builders insist on putting up. They do tend to break off & yes when wet can flake off. I suppose you could always tape some plastic garbage bags or plastic over the ceiling. You can spray the smitereens out of that & not have to worry about plaster coming down. Any that does decide to fall of is going to come off & land on the ceiling side of the plastic, where, until you're trying to decontaminate a room post outbreak, you can just ignore it.

Kas; that's a great idea. The problem with 'fencing off' an area with plastic as opposed to using a separate room is always that it's harder to contain virus. Your idea makes that easier. The fan's use would, (supposedly), draw air IN to the room, your own form of high priced negative air pressure system(!), but that only works if you have a window you can open to the outside & in a small neighborhodd wouldn't exactly be considered 'neighborly' as you'd also be sending virus particles out to the public. Granted, your main concern is YOUR family. Nevertheless it's not something I'd want to do without thinking about it for a bit.

Sorry, DH "moved" my computer tower while I was online, ($@#@$#@###) & my puter is now sulking. Took a while to get my son's to go online. I'm 'bottlegging' an extra online computer & the price I pay for there is that it goes on line when it feels like it. In the meantime, having to do a complete scan disk on mine... GROAN!

But I'm writing the next section...

For anyone curious about how Tom & family are making out, my son is out tonight for 4 hours, so I WILL have at least 1 computer available online. It took me a few days to work out a credible "what's next" for that wretched scenario. Think I got something now...

CanadaSue · #37 10-09-2002, 01:38 PM

At this point you pretty much have every major thing you need in the room. All you need to do is set things up for the benefit of both you & your patient. First things first, you need to make the bed. Remember at first, you patient has fever, aches everywhere & generally feels lousy. He/she has no pox yet & theoretically is not contagious. If they're up to it, this is a great time to send them for a shower or bath. You want them to start this phase of illness as clean as possible. Include a good washing of the hair & the best job possible of brushing teeth & cleaning out the mouth. If you're dealing with a really young one, you can help; to make sure everything gets done properly.

If the child or adult is capable of bathing themselves & you're not worried about them falling/slipping in the shower or tub, you can take this time to make the bed & make sure you're ready. Here's what you need for the bed. The bottom sheet doesn't matter too much right now in terms of softness or quality; just so long as it's clean. Make sure it's well tucked in. Fevered patients often are restless & a sheet mussed up underneath you is NOT comfortable when you're already feeling rotten. OVER the bottom sheet, you might want to put something called a drawsheet. That's simply an ordinary flat sheet folded in half. You place it in the middle of the bed so that when the patient is lying down, the sheet is under them from roughly their shoulders to partway down their legs. It can be easier, if the patient is sweating, simply to change the drawsheet than try to change the entire bottom sheet. Leep the part with the fold nearest the head of the bed.

On top, if your patient is feverish, you may choose to just have a top sheet. Have a light blanket folded up, either at the end of the bed or nearby. Fevers aren't always constant & when a person's temperature goes down, they may feel cold. As well, if a fever "breaks" in the form of a sweat, the patient may feel chilled. You might want to have a towel handy to wipe the worst of the weat off your patient if & when that happens. For the first several days, you don't need to worry about anything else in terms of what's on the bed for bedding. Except a pillow of course.

Patient wear: what should your patient wear? When they have a fever, the answer is 'not very much'. Wether or not you choose to try & bring down the fever in any way, you don't want your patient too uncomfortable. They might feel comfortable just wearing underwear. If you choose to use a nightgown, especially for female patients, you may want to cut them up the middle, at the back. This makes it a lot easier to take them off & put them on when they need to be changed. I've seen manyparents bring fevered babies or toddlers in to be seen & have the child almost smothered in blankets. All that does is hold heat in. Less is more when you have fever. Covering a person too much may increase the temperature & in the case of a child, can lead to a dangerously high fever.

With a high fever, a patient may not be able to take a bath or shower. In any case, why risk sprading virus throughout the house. True, technically a patient is not infectious until they break out in mouth sores, but why take chances. Plus, helping them wash in bed or doing it for them gives you a bit of practice for later, when you really have to bathe them in bed.

You needn't worry about a 'thorough' bed bath. You risk wetting the sheets & tiring out your patient. Concentrate on the face, hands, armpits & groin area for the sake of sanitation. Don't overdo it with soap. You can't rinse as well as you can in a shower & the less you irritate the skin at this point, the better. Bathing your patient in bed is also a good way of spotting any cuts or scratches they may already have. Knowing where these are BEFORE pox breaks out gives you an idea what areas may be most prone to a secondary infection. You may choose to put a bit of antibacterial ointment on any small cuts or scratches, hoping to at least get them partially healed before the pox breaks out.

Use the mildest soap you can. Perfumes, skin lotions & conditioners are fine for a healthy person who can rinse thoroughly but with a person in bed havingonly bed baths, they may cause the skin to become irritated & perhaps cause you problems when the pox erupts on the skin. There are all sorts of very mild, pure soaps out there. Glycerine based, goats' milk, check it out at your local drug store, grocery store or soap specialty shop for those who love good soap. A very mild baby soap is good.

When you're cleaning your patient, here's a hint to keep from having to change the water every 2 seconds... work with 2 basins if you ca& 2 face cloths. One face cloth has the soap... just a bit remember & the other never has soap applied to it. That's the one you use to rinse soap off the patient. You'll find once you have a bit of soap on your first cloth, you probably have to add very little more. Just wet the cloth a bit & it will produce more lather. Wash one part at a time; face first, then rinse. Hands, then rinse. Each armpit next, making sure you tuck a towel under the patient's side where you're washing, to mop up the odd little drip. Then finish off with the groin. The principle is to move from the cleanest part of the patient to the least clean.

After using the face cloths, they can be rinsed in a solution of water & bleach, then hung to dry. In 1 corner of your room, you might nail up a small 'clothesline' for this purpose. It only needs be long enough for a couple of face cloths & a small towel or 2 which are being reused several times a day. Dump the water from your basins into your sewage pail, spray them with your water/bleach solution, then wioe them out & let dry. If you can only come up with one largish basin, (big mixing bowls work great), use that one for rinsing; means less changing of water. Use a smaller bowl just to keep your facecloth with soap wet.

*Hint* Before washing your patient, have someone bring you, to the door or bring in yourself, a pail of warm water. You don't need a ton of it, but make sure it's warm enough to be comfy. You needn't place anything in it. Pure, clean water is perfect. If you can run it through a Berkshire, Katadyne or a Brita first; great. If not, don't worry about it. Most well/city water is clean enough & soft enough not to bother your patients.

If you can & feel like it, you might consider having a box of Baby Wipes handy, by the bedside. Make sure they're the "scent & everything else free" ones. They're handy for small "spot wipes" on your patient & can be disposed. You can too, make your own out of folded paper towels & a small amount of home mixed, water based solution. Somebody later remind me to find my recipe for that stuff. It can be a real time saver.

*Hint* While you may find a roll of paper towels in the room handy, never have too much of it or any other supplies in the room. If your patient does have SP & you don't use a lot of that product, you still have to get rid of it after your patient is healed, assuming no one else comes down with it. For we preppers on a budget, that's a waste.

Don't forget toilet paper for your sick room!

Kasota · #38 10-09-2002, 04:33 PM

CanadaSue · #39 10-09-2002, 07:47 PM

Once again it’s just after supper. It’s Friday & your son is in his room pouting. He “understands” the seriousness of what you’re doing, but it hasn’t really hit home. He’s more worried about the birthday party he’s missing. He’s listening to the radio & hoping his best friend doesn’t hate him for life. You feel guilty about him missing a good time but under the circumstances, not that guilty. Your daughter is on the phone - what else is new? Last time you walked by her room she was bitterly complaining about how paranoid you were. She waited until she heard you on the way back down the hall, then pointedly & not too quietly, shut the door. Fifteen year olds!

Hubby is in the basement, still trying to find that stash old plastic pails. He’s found 4 & swears he has at least another half dozen or so... somewhere. You’re not holding your breath as he’s on his thrid search through the basement & he hasn’t had the best of days. He wasn’t able to decipher the instructions for the new door lock & settled for mounting 2 old chain locks, top & bottom. He promised to have another go at it tomorrow.

You’re worn out. You finished cleaning the sewing room today & did some areas twice, not being too sure how clean they were after the first time you cleaned them. You never did find that blind & the fan you wanted to use for ventilation blew 3 fuses before hubby tossed it into the back shed. In a pinch, you can drag one of the summer fans out of the attic though, you just wish it were a bit smaller & easier to keep clean. Never mind, you probably won’t even need it.

You kept the kids busy today. They dusted & vacuumed, tidied up a few closets & sorted, washed & folded laundry, including the stack of old sheets & towels you unearthed from that storage closet in the basement. They weren’t THAT dirty, just a bit musty from having been stored for so long. You had more than you thought you did & where are you going to put them all? For now, you took all the “good” linen out of the linen closet & stuffed it into a box which you placed on your son’s closet shelf. You really have to talk to him about getting rid of some of those old metal cars & tracks.

You tried to get the kids interested in helping you set up the sick room, but they think you’re demented. Rather than getting into another bun fight with them over it, you told them to keep themselves busy after their chores & to stay out of your way. You’ve been in better moods - only fair to warn them. You placed the furniture you wanted in the room. The camp cot you thought would work out smelled too musty. Instead you hauled up the mattress from the roll away bed & aired it out on the front porch for a few hours after vacuuming the dust off. You sprayed it with bleach & water & aired it some more. You ended up having to take the plastic mattress cover off your son’s bed; a good thing really. It’s been years since he wet the bed & you’ve simply never taken the time to remove it. One spot looked ready to tear; duct tape took care of that.

You made the bed. You got annoyed when you folded the draw sheet the wrong way twice. Fold it LENGTHWAYS, you reminded yourself & make sure the folded end is towards the TOP. A top sheet, a pillow & an old,, thin blanket finished the bed off. The table you wanted to use, that old sturdy, plain wooden one. Nobody told you it had a wobbly leg. You ended up putting in the end table from hubby’s end of the couch. He rarely used it anyway. It’s a bit bigger than you wanted but no doubt if you need it, you’ll be glad you had the room. You put an old goose necked study lamp on it & an empty pitcher & plastic drinking glass, to be filled with water should you need it. You put an old plastic kid’s cup there too, for a thermometer. The thermometer you placed in the drawer, along with a plastic clipboard, some loose leaf paper & a couple of pens. You placed a half dozen acetaminophen tablets in a small plastic storage container - just in case.

You resurrected the old vinyl beanbag chair from the basement & wiped it down. Beside that you placed an old square plastic storage bin, upended where you could put a book, a flashlight & anything else you might need. By the wall near your chair, a second table. On it inside a plastic bag, a spare set of sheet, a couple of face cloths & 2 towels. You’ve also placed a bar of baby soap on an old plastic saucer & a spray bottle of bleach & water. Oh heck, you forgot the plastic spray bottle of the same stuff for the bedside... later.

You cleaned out the 4 plastic pails hubby found & they’re stacked inside the door for if you neeed them. You make a mental note to yourself to have one of the kids clean the boot mat, the new one & to find you a couple of magic markers. One of them must have one in their room somewhere. You’ve bought them enough over the years for various school projects. You don’t have any wash basins per se, but the 2 huge mixing bowls in the kitchen will do. You’re not quite sure what you’re going to do for a bedpan. Somehow, you never thought to buy one.

Your sewing room is just across the hall from your bedroom at the end of the hall. You had hubby drag your dresser over a few feet & grabbed an old metal shelving unit from the garage. You cleaned it & put it where your dresser was. On it you’ve stacked some extra linen, a small bottle of concentrated cleaning solution & any number of plastic bags. You have a box of medical gloves & 2 large pairs of household rubber gloves. In the morning, you’ll haul out your 2 old sets of sweat suits.

Somewhere in all that work, you found time to inventory, roughly, your stock of pre-cooked meals in the freezer. Not bad - lots of stew & soup in there. In fact you’d better think of eating some of them up & making more. Some are looking a bit on the old side. It might be a good idea to make some different soups, just for variety. Your daughter can operate the bread maker, you’ll have start dough for rolls, remind her how to shape the buns & have her bake them for you. A few dozen rolls in the freezer might be a time saver later.

You’re feeling a bit miserable. Fatigue no doubt & worry about what could be happening. A few times today you phoned friends to find out what, if anything, they’ve heard. 2 friends mentioned a number of people sniffling at work & a few absent but word has it it’s just that early flu. You hope so. Your daughter tried to phone her friend, Elaine, but no one answered. In your mind that makes it even more likely Elaine is the girl in hospital. You’ve driven the kids crazy asking them how they feel roughly every hour. FINE! Maybe you should ease up.

Your husband finally comes upstairs - no luck finding those pails. At this point, you could care less. It’s been a busy day. He pours you both a cup of tea & you both settle in for the early local news. A serious looking local anchor, the one who usually does the late news comes on & the lead story is the illness sweeping your city. Sweeping? Last night it was a few people hospitalized, mainly as a precautionary measure & ‘several’ people being checked out for what appeared to be a nastier strain of flu than what had been going around. The anchor gives some facts. All members of the original case’s family have now been hospitalized & the parents of those attending the kids’ schools, (the names are repeated), are asked to watch their kids for the following symptoms: high fever, overall body aches, nausea & possibly vomiting, headaces & ANY sortt of rash. A special warning to check for any sores in the mouth. Any parent noting such symptoms or any staff members at the school or any shoppers who were at the Safeway at Middle Hills Shopping Center in the last few days & have such symptoms are asked to call... and a list of three phone numbers is provided. People with these symptoms are asked to NOT come to either of the 2 hospital’s emergency rooms.

The Chief of Medecine of your local hospital speaks next. He starts by saying that since late yesterday afternoon, 23 people have presented to the emergency room with symptoms as follows - he goes on to list the symptoms the newscaster gave & reiterates the caution that anyone having these symptoms call the numbers given. They're repeated. He adds that fifteen people have been hospitalized, in isolation, for high fever & in some cases, an odd rash.

A number of local reporters try to ask question at this point but are ignored. A spokesman from the other local hospital, an HMO hospital, then addresses the small crowd of reporters. 17 people with similar symptoms reported directly to the emergency room yesteray; 11 had to be admitted for symptoms similar to what is being reported from University Hospital. HMO patients with similar symptoms are also asked to use the numbers called instead of coming to hospital.

The local Director of Public health is next to speak. He states that between patients reporting to hospital & those being referred by the doctors or local clinics, a total of 68 people have been identified with serious manifesations of these symptoms. Those who haven't been hospitalized, a total of 36, have been sent home with instructions to call a special number should they begin to feel worse or develop a rash.

He cautions the public against undue worry. While this appears to be serious, no one is in critical conditon & most of those admitted have been young children & the elderly. He advises those in those age groups, as well an anyone on anti-rejection drugs or those who are immune suppressed to limit their contact with the public. The state Dept. of Health has a team on the way to investigate the outbreak & the Centers For Disese Control i Atlanta has been notified. No, there is no diagnosis yet, but with the outbreaks centered around 3 locations, it may be environmental. His office is checking to see if the schools affected bought any food or drink items from the Safeway, to rule out a connection.

The press conference is ended at that point & after a few comments to the weatherman about how "odd" this sems, the news anchor moves on to other local stories.

Later on the national news, 2 of the networks pick up on your big local story, but it onlre recieves passing mention with guesses that it might be Legionnaire's Disease, a form of meningitis or a local environmental problem. There is no mention made of this anywhere else in your state or the country.

You & your husband look at each other; this isn't sounding too good. But, you're prepared & have no plans to go anywhere for several days. You finally get into that bath you've been promising yourself & your husband turns on a hockey game. By nine o'clock, you're ready for bed. Your son promises not to stay up too late & your daughter admits the work today has tired her out as well. She feels sleepy & plans to get to bed very soon.

...That's how it might intially play out. A number of cases of 'unusual flu' are reported & while health authorities won't speculate on the nature of the illness, they caution people to be careful, to report unusual symptoms & for those at risk to limit outings. To me, that would be a bunch of red flags. Unsual numbers, unusual symptoms, warnings to 'be careful' & any time they give a number to report symptoms.

Preppers might catch on, but ufortunately, themajority of people, if they even caught the news, aren't going to let reports of flu stop their plans. So they go out... to movies, evening shopping, sports events, parties, etc.

And the virus spreads...

Loretta Van Riet · #40 10-09-2002, 10:23 PM

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