Remote Alaska Healthcare

Among the top questions people ask us about living on our own in the Alaska Bush are,

“What do you do for medical care? What would you do in an emergency?”  These are insightful inquiries, especially since four months a year there is NO transportation to/from our cabin, except, when feasible, by an emergency helicopter.

Obviously, we can't take care of every awful scenario, but we have endeavored to assess health risks here and mitigate them where we can.  I imagine that our approach might be prudent for any home, anywhere, especially since national statistics indicate that about 30% of all emergency room visits are the results of injuries, https://www.nsc.org/home-safety/tools-resources/odds-of-dying/emergency-room-visits, particularly falls. For us, I imagine that dirty cuts by power and passive tools could be a problem, and possibly burns and lung issues, too, since we heat the house and hot tub with wood fires every day.

OUR SOLUTIONS, SUCH AS THEY ARE

“SUCK IT UP” ATTITUDE

Let's face it. Anyone who lives like this cannot be a whiner or a hypochondriac. Besides, I hail from stoic stock. My brother drove himself to the hospital when he cut his leg with a chainsaw! When I broke my wrist (in suburban California), the system was so backed up that they couldn't give me a cast until three days later. So here in the Bush, when I have sprained a finger, broken a toe, snipped off the end of a finger, had painful shingles, my message to myself was “deal with it yourself.” Been there, done that.

WORST CASE SCENARIO EMERGENCIES

If we absolutely needed to get to a doctor, my husband could fly me 20 minutes to Willow, where our doctor has a 1/2 time office, and we could drive another hour to the nearest hospital. However, since I am not a pilot, if HE needed to go to the hospital, I would have to call a flying friend, hire an air taxi ($220 for both of us, one way) or hire a helicopter pick up ($1000). I am sure that a medical helicopter would cost a lot more, but perhaps in line with what rural people anywhere in the country pay for ambulance and medivac services to a distant facility.

PURCHASES TO AVOID INJURIES

Since we lack professional healthcare training, our biggest health-related focus is on preventing medical injuries that could occur from accidents or repetitive movements.  Beyond that (see below)

Winter roof construction

we have studied a lot of sources to help us. 

• For various chores involving power tools, chainsaws, guns, and climbing the power tower or roofs, we wear safety glasses, gloves, ear protection, hard boots, kevlar chaps, hard hats or rappelling gear. A few adrenaline-inducing experiences have justified that prudence!

• 

  Give moose families lots of room

  Repetitive actions can wreak havoc on joints. So, a friend created a chain and claw device we use for lifting logs without bending over. We also bought a log splitter that has cut up thousands of logs in the past few years. We still use a hand axe, too, but we don't have to use it to cut up eight cords of wood each year.

• 

  Lots of home grown potatoes

  We wear cleats over our boots when it is icy and pat out paths in snowshoes after a dump of snow. A simple piece of advice came from a physical therapist, who told me that flat, uncushioned shoes, like sandals and rubber boots, can be as bad for the knees (the reason I visited her) as high heels can be for the foot. Hello, Dr. Scholls! - I love the $17 foot inserts in the slip on/slip off rubber boots that I wear here all summer. 

TRAINING and BOOKS for INJURIES and AILMENTS

The following courses and their books have been very useful references:

• Red cross emergency certification
• Scout wilderness medicine
• Herbalism certification (www.theherbalacademy.com - wonderful online courses and community)
• University classes in the Chemistry of medicinal plants and Ethnobotany
• I am currently studying an Anatomy and Physiology textbook
• Master Gardener certification
• Master Naturalist certification

The books we have found useful include:

• the Be Prepared First Aid series
• Medicine for the Outdoors by Paul Auerbach
• Red Cross's Wilderness and Remote First Aid
• Alton's Antibiotics and Infectious Disease by Joseph and Amy Alton
  
  For my home remedies:
• I value The People's Pharmacy books by the Graedons for very well researched comparisons of prescription and over the counter drugs as well as home remedies.
• The Modern Herbal Dispensatory by Thomas Easley and Steven Horne
• The Herbal Kitchen by Kami McBride (food as medicine)
• Alaska's Wilderness Medicines by Eleanor Viereck
• The Boreal Herbal by Beverley Gray, and
• The Complete Medicinal Herbal by Penelope Ody
  Survival and Austere Medicine, 3rd Ed., 2017 (free .PDF download)

MEDICAL CARE

• Our doctor said that annual blood/urine tests can reveal much more information than an annual physical exam. She encouraged us to get routine blood tests once a year and alert her if any numbers are out of range. (In Alaska, very sensibly, I think, one does not need a doctor's prescription to solicit blood tests)
• When we were in India recently for business, I had a thorough "well woman"check up (for $40), which included EKG, chest X ray, and abdominal organ sonogram.  These will serve as excellent baselines, since I have NEVER had those done in the US.  

HOME REMEDIES

• I forage/raise medicinal plants and make them into salves (with beeswax, olive oil, lanolin), liniments (in rubbing alcohol or witch hazel), and poultices (chewed up or macerated and heated) for topical applications and teas and tinctures (in vodka or vinegar) for internal administration.
  Daily care: Every day, we sip a tablespoon or so of a Master Tonic, which is vinegar with onion, garlic, horseradish, ginger, turmeric. It tastes better than it sounds and the ingredients which confer prophylactic advantages including anti-microbial, anti-inflammatory, decongestant.
• A few times per year, we chew juniper berries over a 9 day schedule as a liver cleanse. 
• Many people recall their grandparents utilizing some of the home remedies we deploy to address minor ailments so they don't get worse:
  * Ear ache: dribble in some hydrogen peroxide three times a day.
  * Muscle aches: cayenne oil (warming) and comfrey/mint liniment (cooling).  
•    Splinters and stingers: plantain and chickweed poultices draw them out.    
•    An open cut: slather (anti-microbial) honey on it after cleaning.   
•    Sore throat: gargle with salt water, soothe with honey tea.   
•    The herbal teas I sip each day derive from the summer's bounty of dried or fresh leaves and flowers, with vitamin rich birch sap as a spring tonic. My resource books inform me about the vitamins and actions inherent in such flavorful plants as dandelion, fireweed, raspberry leaf, mint.
• I adjust the spices in my cooking when needed to increase salivation, improve digestion, clear congestion, increase circulation, calm nerves, improve sleep.
  I take our daily bath (in a wood fire heated barrel) seriously as a therapeutic as well as hygenic break. We “dry brush” our bodies before baths to exfoliate dead skin cells and stimulate circulation. The hot water soothes sore muscles (and arthritis in guests), increases circulation and heart rate, improves deep breathing, and calms the mind. Weekly facials and hair treatments with honey moisturize and others with bentonite clay masks on hair and face supposedly draw out metal toxins. I wonder how much people pay at a spa for an hour of this?

PURCHASED EQUIPMENT and MEDICINE:

We continue to acquire medical supplies as we think of something logical.

• Used, military medical kit
• New medical and dental equipment sold in India to non-doctors/dentists
• Physical aids in case of need, like a cane, knee/ankle/elbow braces/finger and arm splints
• Epipen
• Generic medical supplies, like heating and ice packs, bandages are frequently useful.
• At first, we bought a lot of over the counter drugs but have not used them. Conditions that we occasionally endured in the city, like constipation or diarrhea, stomach aches, headaches rarely happen since we moved here. On the other hand, we do get more muscle aches, cuts, scrapes, and bruises!

In conclusion, we are not cavalier about health issues and injuries that could happen here. We are fortunate to have no chronic or acute health problems and to require no prescription medications which could be problematic for others in this situation. So we try to keep ourselves healthy and safe and to assemble supplies for times when we are not. After that, I imagine that we will be just as surprised and alarmed as anyone else who ends up in an emergency room.