Fishing for a cure
Modern medicine is wonderful, and has conferred amazing
benefits upon us all. Unfortunately, modern doctors, administrators,
lawyers and government officials are as flawed and unresponsive as ever
- little progress made there. In few places is this as apparent as with
the medical response to Lyme disease. I openly admit to a bit of a
preoccupation with Lyme. I spend a fair amount of my time outdoors, and
live in a semi-rural area in which Lyme is endemic. I am bitten by bugs
all the time. Waukesha county is considered a Lyme hot spot, and cases
are increasing rapidly. Local vets in the area are constantly warning
dog owners about the danger of Lyme, and regularly treat the condition.
A dog in my subdivision has been treated for it twice. Yet local
doctors have little to say on the matter, in regards to treating
humans, and are suspiciously quiet. How is it they don't seem to know what all the local vets know?On May 5th, I woke up with a raging headache, ringing in my ears, stiff neck, and pain in both elbows. I am getting older, and you never want to believe the worst, so I tried catching up on my sleep a bit, and was careful to take care of myself. I also began to notice some significant memory issues, and some trouble concentrating. I suspected this could be distraction due to the headaches, sleep deprivation, or possibly age related, though it was significant that it had happened so quickly. When there was no change, I went in to see my doctor on May 19th.
He advised me that the ringing in my ears was due to wax and possible congestion, the headaches were sinus headaches from allergies, and my elbows hurt because I must have strained them lifting something. He blamed the memory issues on my age - though I am 57, not 87. When I suggested Lyme, indicated by my combination of symptoms, he dismissed it like it was the silliest thing he ever heard. He then offered to prescribe a pain pill for the elbows, and an antihistamine for my sinuses, even though I was not sneezing or showing any signs of congestion, and have a desk job and do little heavy lifting. I refused both prescriptions. He then quickly fled the room, having given me his usual 7 - 10 minutes, and sent in a medical assistant to squirt water into my ears to clean them.
I have to admit, I was relieved. I didn't want Lyme, and was happy to think that it was something simple. He was the doctor after all, and should know. Yet, my ears were still ringing, my head still hurt, my mind was in a bit of a fog, and my elbows still bothered me. I waited to see if things would clear up, and then returned a few weeks later, this time with additional complaints. All of my old symptoms were still present, but now I had some numbness in my fingertips, and my concentration was getting worse. I was also mispronouncing words and stumbling over them, and was getting really short tempered and grouchy. My elbows now hurt worse, and I was having trouble sleeping. Whatever it was, I was clearly not improving, and so far had received no treatment of any kind.
This time I had been careful to make a list, documenting my complaints, and their occurrence, including a bleeding sore I had taken for a spider bite, partway down my ribcage, that had manifested itself around the same time as my other conditions back in early May. One by one my doctor discarded each of my complaints, attributing them to unrelated things, age, or to a hypochondria on my part. He advised me that ringing in the ears was not a symptom of Lyme, which indicates either dishonesty or ignorance on his part. Both the CDC and NIH web sites, as well as that of the National Lyme Foundation, indicate ringing of the ears a common symptom of Lyme. It also seems strange to me that a patient complaint of constant ringing in the ears for two months after a sudden onset would not be a matter of concern.
When I advised my doctor of my web findings, he said, "That's all bullshit, and you should know better." While I am the first to admit that there is much misinformation on the web, the NIH (National Institute of Health), and the CDC (Center for Disease Control) are hardly fly by night outfits; neither is the National Lyme Foundation. This was when the last bits of credibility of my doctor evaporated. My search for a new, more responsive and competent doctor, began that day.
When diagnosing Lyme, because of the stages of the disease, and the variability of symptoms, a clinical diagnoses is made. That is to say, the disease is diagnosed according to symptoms the patient shows, rather than lab tests. Tests are used only to verify a diagnoses already made, and only after treatment has already begun. This is in the same manner as rabies, Alzheimer s, and a number of other diseases which either have unreliable tests, or for which immediate treatment, which should not wait for testing, is required.
At this point I demanded doxycycline, to which he replied he would do no such thing without a definite positive test for Lyme. He did relent enough to finally schedule a Lyme test, which I dutifully took, but had already decided to ignore. Lyme tests are 50% - 65% accurate, and are very dependent upon which stage the disease is in, which lab processes the test, and which particular test you take. There are three tests for Lyme; one for T cells, one for antibodies, and then the Western Blot which tests for actual Lyme artifacts. All three should be requested. He scheduled me for one.
This is no longer my doctor. This whole thing will probably end up costing me about $1000, including multiple office visits, testing, and of course the fee for getting my ears cleaned, and resulted in no treatment. I am seeking a new doctor; but in the meantime I can not continue to let this go untreated. To find another doctor, get an appointment, get a diagnoses, and get a prescription will take at least another month. There is always the chance that the new doctor will struggle against this like the old one, for reasons I will get into at the end of the page. The clock is ticking with Lyme, because it is quite simple to treat in its early stage, but gets notoriously difficult later on. So I had to get treatment. There are holistic medical practices out there, but frankly, despite my bad experience with traditional medicine, I am not very confidant about the holistic practices. Much of holistic medicine comes pretty close to quackery. If I wanted a quack, I would keep the doctor I have.
I will act as my own doctor.
There are several ways to treat early stage Lyme. All are simple and effective, yet all must be used while the disease is in its early stage. Once the disease disperses (disseminated Lyme is what it is called at this stage), treatments become less effective, more complex, far more intrusive, and need to be somewhat tailor made. Allowing the disease to run untreated for any length of time also allows it to attack longer and do further damage. You may completely recover from this damage, and you may not. At the disseminated stage, the disease may settle into the joints, nervous system, the heart, and other organs, and be very difficult to get rid of. At this stage it can cause arthritis, nerve damage (to the extent that there are suggestions that ALS, Parkinson s, MS, and other diseases may be linked), menegitis, heart damage, and possible liver complications. If this is Lyme, I have had it approximately two months now.
Azithromycin is slightly more effective than doxycycline for Lyme, according to a recent study. It is also far more convenient, and may be dosed once a day for several days, instead of three times a day for two to three weeks. This is because it has a long half life in the body - approximately 68 hours, as opposed to about six hours for most drugs. I am following the recommended protocol for Lyme, which is a double dose the first day, followed by a single dose on the next five days. I have purchased 12 tablets, which will allow for up to ten days of dosing - recommended if the symptoms do not show some abatement during the first course of treatment. Treatment started on June 27th, after onset on May 5th.
I have worked out a chart of what the daily average amount of Azithromycin in my body will be on a given day. This is based upon the half life of 68 hours, and the initial 1000 mg dose, compounded by the daily 500 mg doses.For those who think I am a nut case, in way over my depth, I include the following passage taken from the emedexpert website:
http://www.emedexpert.com/compare-meds/azithromycin-vs-doxycycline.shtml#ref6
Day 1 (2-Azith 500 - dose in body 1000)
I took my first dose at 1:00 PM, and then attended a local event until about 4:30. Returning home, I felt a little tired, and fell asleep in the afternoon. I felt kind of funny, dreamy almost. Slept several hours and woke with a cold, which I did not have before, and have been sneezing all day. Energy is good, and I was able to attend a local ham radio event this evening. Ears still ring, and elbows still hurt. Headache is also about the same.
Day 2 (1-Azith 500 - dose in body 1300)
No real difference. Still sneezing, and eyes watery. Ears still ring, and elbows still hurt. Headache is a bit diminished. Neck is not stiff. Got the runs, which may or may not be related. The air "smells funny".
Day 3 (1-Azith 500 - dose in body 1550)
No headache, ears still ring, though it is sporadic. A bit sneezy upon awakening, and retain watery eyes; but this is diminishing as well. Writer's block is gone, and I am able to write this, as well as a pictorial on ham radio field day. Cleaned the house, and feel somewhat more energetic. Back at work on my "Walter" story - I make some extra money writing on the side, to supplement what I earn as a computer tech. It is amazing how clear my thinking has become.I had almost forgotten how well my mind can work. I will not attribute this totally to the drug. I have been getting a lot of sleep this weekend. Yet for two months I have been unable to do any significant writing, and in two days I finished three pieces, and polished up another for submission. The runs are gone, and really only lasted for the first day. I am aware of the placebo effect, and of the power of mind over matter, yet this seems to go beyond that, particularly in the case of the runs - you don't just wish that away.
Day 4 (1-Azith 500 - dose in body 1725)
Headache is gone - gone! Ringing in the ears is greatly diminished, and had disappeared completely for much of the day - for the first time in two months, my ears stopped ringing. This is ironic, because ringing in the ears is one of the possible side affects of this drug. Right elbow pain is gone - it is a bit achy, but the sharp pains have disappeared. Left elbow still bothers me, but does not seem nearly as bad. When I took my shower this morning I was able to dry my hair without the sharp pains and burning in my elbows that I have been dealing with for the last two months. The sneezing has stopped.The numbness in my fingertips is gone.
Day 5 (1-Azith 500 - dose in body 1875)
This is the go/no go day, where I decide if I will double dose or stop taking the drug.
I can not believe the changes that have occurred, and how quickly. I have to admit, I was feeling a bit crazy there - wondering if I was some kind of whiny nut case. My doctor is supposed to know, and he strongly suggested this was all in my head. I did not discount the possibility of hypochondria. Yet this is the proof. Headaches, stiff neck, difficulty concentrating, problems with words are all gone, yet can all be subjective things; but the improvement in my elbow joints is definite. My right elbow does not bother me a bit. My left is still a bit sensitive, but does not hurt. ringing in the ears is diminished in intensity, and no longer constant - it comes and goes. It is possible that this is a result of the medication (ringing in the ears is a possible side effect of Azithromycin), and my original condition has cleared up. I did a dose chart, based upon what I have been taking, and the half life of 68 hours, and have determined that this means there is a dose of 1875 mg in my body right now. This will be cut in half every 68 hours, about every three days. This is a hard decision to make, as the drug absolutely seems to be working. The normal course of treatment for Lyme is now over. If my doctor had done his job, this is when I would now be discontinuing treatment. So I will stop now, and reassess on the tenth day.
After 6 days (dose in body 1500):
I still don't know for sure that this is/was Lyme, though I am fairly certain. Yet, whatever it was it responded to antibiotics. I am fine. My head no longer hurts (the first symptom to disappear), no more stiff neck, the ringing in the ears is intermittent, and much diminished. I have high hopes that it will be gone after ten or fifteen days. My memory and concentration are better, and are approaching what they once were. I have good indications that I will get it all back. My right elbow no longer hurts. My left elbows is much improved, having subsided to an occasional dull ache, a vast improvement over the shooting pains and burning that manifested themselves for the previous two months, with the hope that it will also completely recover. The numbness is gone, though two of the fingers on my left hand ache a bit. I am also hopeful that this too will pass.
I stopped dosing after five days, but with a half life of 68 hours, there is still 1500 mg of Azithromycin in my body. So I am still strongly under the effect of the drug. After 10 days there will be 590 mg. I will update this page at that time. A week later there will still be over 100 mg in my system, as much as during the middle of a doxycycline protocol, and a week after that a little under 50 mg. So five days of dosing keeps a significant amount of this drug in your system for three weeks. I still have six tablets left, as well as the 100 mg doxycycline capsules, in case the infection makes a comeback; but I don't think it will. I believe it to be gone, which is a huge relief. My suspicion is that the remaining ache in my left elbow, and the now reduced intermittent ringing in the ears are a result of damage already done, rather than active infection, and will stop as my body recovers. I will also update this page after three weeks have passed, which will essentially be the end of the treatment.
Those who are skeptical, jaded, and think I am crazy or irresponsible - I felt the same way. But I had to do something.
Had I waited, done nothing, and trusted my doctor completely, this would have developed into long term disseminated Lyme. There is a possibility that after two months, it already has, though I am hopeful. The scary thing about this is that it can seem to get better and go away - Lyme has cyst forms, and can go dormant. It can then come back, months or years later, and not be connected with the original infection or observed tick bite. Treatment of late stage Lyme is far more unpleasant, involved and expensive. It is also somewhat tailor made. The more powerful medications, often administered via IV, are much more likely to have serious side effects. The long term damage is much more likely to be permanent. You don't want late stage Lyme.
My former doctor misdiagnosed, mistreated,and ignored what was wrong with me, even as he took my money. He, not quite unknowingly, set me up to risk chronic long term Lyme, when all that would have been required to head it off was a simple prescription for a common non-addictive, and non restricted drug. Yet he didn't technically do anything that made him culpable. He wasn't a bad doctor, by today's standards. He just wasn't a particularly good one. That's the whole point.
I can not afford to entrust my care to such a man. Religious beliefs aside, this is the only life I have to live, and this is the only body I get to live it in. The jury is still out, on chronic Lyme. Some say you can not die from it, while others believe it is like Pneumonia, where it weakens the body to the extent that it will die from a combination of things that it would otherwise be able to resist. Though there is argument about Lyme being life threatening, there is no argument that it is life affecting, greatly reducing the quality of life, and often reducing people to a shadow of what they once were.
We have been brainwashed to believe that our lives are the responsibility of someone other than ourselves - almost to the extent that we might believe it is the responsibility of anyone other than ourselves. In medicine this means that we are not allowed access to life saving, or life enhancing, drugs and techniques without the permission of our doctors. The doctors, in turn, are closely monitored by the AMA, FDA, and similar organizations, and are closely reined in by the insurance companies that have become the true driving force in medicine these days. This encourages many doctors to become less concerned with being good doctors, than with being blameless doctors. As much as I hate obamacare as a way to assert control over our health care, really this control was already relinquished decades ago.
There are a number of doctors, several right here in Wisconsin, that have been put through the wringer for effectively treating and curing Lyme disease. In all such cases, charges have been brought, not by patients who were happy to be cured, but by insurance companies that did not wish to pay for treatments, even when effective, if any possible justification could be found to withhold treatment. Between the sleazy insurance companies, and the equally amoral lawyers, many doctors feel they are walking a tightrope, and are afraid to point out a shadow on a sunny day without verification by a lab test.
So where did I get these prescription medications? They came from Thailand, where the presence of insect borne disease, including malaria, is so common that powerful antibiotics are available over the counter, like aspirin. I now have in my presence 100 capsules of doxycycline, and an even dozen of Azithromycin. I also have some Flagyl capsules, though I sincerely hope I will not have to use those. Flagyl is truly scary medicine, and can do nerve damage. Yet it is a medicine typically used to treat late stage Lyme, which is one of the reasons you never want to let it develop into late stage Lyme.
There are basically five places to get prescriptions for antibiotics, and for a few other things:
- Accommodating doctors: This is the best approach. If your doctor is an idiot, coward, lazy, or thinks you are an idiot, dump him. Get a doctor who trusts you, respects your intelligence, and doesn't think he is God on Earth, and you are a mere mortal. From such a doctor you can get proper medication, monitoring while undergoing treatment, and proper follow up. Sadly, such doctors are going the way of the dinosaur. When we used to pay for our own treatment, and the nation was not sue crazy, this was the kind of doctor almost everyone had. Now the customer is the insurance company and they get to demand protocols and limit treatment. In concert with this are the many government agencies, mostly run by lawyers and administrators, who have decided that they are more suited to determine treatment than doctors.
- South of the border: If you live near Mexico there are many antibiotics and other medications that are completely over the counter. Under Mexican law, these substances do not require a prescription. There is a rather thriving business in places like Tijuana, where there are a number of pharmacies right across the border. The United States was like this, until 1951, when the Durham-Humphrey amendment to the food and drug act made it illegal to dispense a number of drugs, including antibiotics, without a doctor's prescription. before this, your pharmacist was still a genuine health care provider, who could recommend medicines, and treat certain conditions.
- Pet Medications: Sad but true. Pet medicines are made by the same pharmaceuticals, and are usually taken from the same exact production runs as human medications. The pills will have the same markings, and are the same pills. Medications for dogs and cats will usually need a vet prescription, though many pet med on line sources have a vet that will automatically rubber stamp a prescription for any order you place. Easier to get are bird and fish medicines, at any local pet store, which are also the same as human medicines and require no prescription. There are some guidelines, and if you decide to go this route, you may wish to do a little research on the web. I have included some links.
- Export pharmacies: Avoid
these places like the plague if you can. This
is blatantly against the law. It is the luck of the draw that your
order gets through customs, and on top of that you risk counterfeit
medication, in addition to possible fines or jail time. The FDA
constantly warns against this, and it has become one of their pet
peeves. Generally you will see these advertised as Mexican or Canadian
pharmacies, which is a load of crap. In most cases the medications come
from Asia or the Middle East, if you get them at all, and if they are
what they are claimed to be. FDA testing determined that many of
these medications are of poor quality, ineffective, and sometimes
completely counterfeit.
- The black market: Is there even a need for me to say anything about this? Medicines
from this source are almost guaranteed to be expired, counterfeit, of
poor quality, tainted, or some combination of these things.
Ordering pet medication
Well, I tried this route for a while, and have to admit I
felt like an imbecile. So I bought the fish flox, the bird doxy, and
the aqua forte. I also lied to on-line vets; but it wasn't really
lying, since they expected me to lie, and were prepared to pretend to
believe my lies so that they could write a prescription for the dog we
both knew I didn't own. In the real world, vets dispense medications
themselves, or send you to local pharmacies. You don't get a
prescription for your dog, and then go on-line to fill it, and the
people who run these pet med places know this. I sent in an order for
30, 100 mg doxycycline
tabs (the human dosage), and described the tick that my dog Abbey
picked up on her romp through the woods - except that I don't have a
dog. I was going into pet shops and asking clerks what I might use to
take care of fin rot in my angelfish - except that I don't presently
have angelfish. It gets ridiculous - buying enough fish medication for
thousands of gallons of water, and the clerks knowing full well what I
am doing, because they have seen it many times before.
There has to be a better way.
The better way is an importer down in Florida, who imports medicines for pet use, as there is a huge exotic pet trade down in Florida. The tropical climate, favorable legal climate, and large affluent population mean that everything from alligators to apes are kept as pets. There is also a large Hispanic population (used to easier access to antibiotics back home), and a fair amount of international traffic - legal and illegal. What this guy does is import medicines manufactured to treat humans. He gets them from places like Thailand, where they are either over the counter, or available for export for legal purposes at the country of destination. He then takes this human medicine, some of which still has directions for use by humans, and affixes stickers advising for veterinary use only. This is legal because these medications are approved for use in aquariums or for birds. Affixing warning labels advising these are not for human use suddenly makes them legal to sell without a prescription. As has often been stated in many places and for many reasons - "The law is an ass."
So what can you get? The list is really quite surprising.
Doxycycline
Azithromycin
Erethromycin
Penicillin
Amoxicillin
Ampicillin
Ciproflouxine
Metronodiazle (Flagyl)
Sulfamethoxazole
Cephalexin
Clindamycin
Fenbenzadole
Tetracycline
Fluconazole (diflucan)
You can look these medications up on the net, and see the
variety of afflictions they treat. Basically, just about any antibiotic
medication is
available. There are a few exceptions, and nothing for injection or IV
use is available; but the layman wouldn't want to screw around with
that kind of stuff anyway. With the medications listed above, anything
from Lyme, though blood poisoning, malaria, STD's, strep, staph, and
anything else infectious that you can name can be treated. These are
the wonder drugs that can cure anything. They're too good for the likes
of us, without special permission; but are fine for use with our dogs,
cats, and fish.Please note in these photos that these particular medicines were were not originally manufactured for aquarium use, unlike the examples shown above. Underneath the stickers affixed by the importer, you can still see the original packaging with instructions for human use. While I understand that the made for fish medications are the same chemicals, manufactured to the same standards, and work just as well. I get a better feeling using human medicines.
What is not on the list, and should not be, are narcotics, certain opiate pain killers, amphetamines, barbiturates, and psychedelics. Interestingly, a number of such things can be easily gotten over the counter or on-line, far easier than most antibiotics. It is ironic to note that as far as psychedelics, euphoraites, intoxicants, and hallucinogens - maybe some cocaine or heroin - these are available at your local street corner. It is also relatively easy to get diet pills, sleeping pills, and non-narcotic pain killers - so the worst drugs are the easiest to get. I have a list of links below, but have not included my own source of supply, since I do not wish to have him shut down.
So why do this? A look at what happened to me is a pretty good indication that you can not afford to put your full trust in any doctor, particularly one that does not have full trust in you. Incidentally, my Lyme test results were negative (50% - 65% accurate - remember?); but I clearly had either Lyme or something that responded to treatment for Lyme. Further influenced by the test results, my former doctor would never have treated me, and I would have continued to get worse. Eventually I would have found a better doctor, who would have recognized what I had and treated it, or I would have become so sick that even my former doctor would feel the need to do something; but after how long, and with how much recovery time required? You hear stories about Lyme sufferers going years before being properly treated, often resulting in chronic damage to body systems that is never fully repaired.
Other good reasons are matters of convenience and finance. An office call, with our new wonderful obama friendly insurance, is now over $100, and emergency room visits are over $500 - though my current clinic now offers urgent care at usual office visit prices. For strep, basic infections, colds that have developed into respiratory infection, and the like, why wait days for an appointment and then pay $100 - $150 so that your doctor can spend the usual 7 - 10 minutes to tell you what you already know, and prescribe the drug you already know you need?
One of the big advantages of using human designated
medicines is the appropriate doses they have, and the fact that they
will generally be in pill or capsule form. many of the fish and bird
medicines out there are now in powder form. This is in part because so
many people have become aware of their efficacy for human treatments,
that the pet med industry is trying to save themselves from the
possibility of impending legislation. So putting the powder into
packets, instead of capsules allows for the visible pretense that these
are completely different medicines. It has two other effects. 
These
things taste terrible, and cost more.The package shown to the left contains ten packets of Erethromycin, a very effective antibiotic (though not suitable for Lyme). Up until a couple years ago, such a packet would have contained ten pills or capsules. This is the same erythromycin your doctor prescribes, as a look at the ingredients will show. In emergencies, if you can not wait for a web based order to arrive, there is always the local aquarium store. The back of the package contains directions on how to treat a variety of fish ailments, and gives dire warnings about prohibitions against human use.
Inside are ten foil lined packets of the drug, in powder form, all ready to be mixed into your aquarium. This package will probably cost around $15, give or take a few. This is a very expensive way to buy erythromycin, far more costly than at the local pharmacy. For most conditions, the 10, 200 mg packets will last about five days, meaning that for the normal two week course of treatment you will need three packages. Frankly, the stuff tastes unimaginably terrible. Imagine quinine and rock salt concentrated and mixed together. Back in the old days, when quinine was taken for malaria, someone got the idea of adding lots of sugar, and then carbonating the water - tonic water. Then someone got the even better idea of adding some gin - the gin and tonic. For medicinal purposes of course.
Cheers.
Hunting/camping/survivalist
For hunters, campers, long distance cruising sailors, or
survivalists, the stockpiling of antibiotics, along with other medical
supplies, is a priority. Good luck getting your doctor to write you a
script for a month's worth of doxycycline, or a couple hundred
hundred doses of Ampicillin. Back during the Anthrax scare, you
couldn't get your hands on any Ciproflouxine (cipro), for love or money. Today you can get
it at a fish store. Things change. If I'm sailing across the ocean, or cruising the islands for a couple weeks, I will want to be prepared for a medical emergency in the middle of nowhere. If I am taking a two week hike in the backwoods of Alaska, I can safely assume that there will be no doctors, paramedics, or drug stores there. The simplest things can get serious quickly. If a tooth filling falls out, and an abscess forms, you can be dead in a couple days. If you gash your arm on a rock, and get an infection, you will be feverish in a day or two, and dead in a week. Our ancestors knew all about this, just a couple hundred yeas ago, when human lifespans ran for about 40 years.
If I am preparing for the collapse of civilization, I might want to consider that drug companies will no longer be pumping out pharmaceutical - and the end of civilization could last for a long time. For those of you who consider yourselves survivalists and are stocking up on guns and bullets, consider what will happen if you get shot and there are no medicines. The assault rifle that cost you well over a thousand dollars will be a welcome addition to the gear of whoever finds it after you die for want of a $20 packet of Azithromycin that might have eradicated the infection you got after cutting your hand.
Yet what's the point of stocking up on drugs that will expire in a couple years, or sooner? One of the dirty little secrets of pharmaceuticals is that most dry (pill/capsule) antibiotics have shelf lives of 15 - 20 years. This is according to an FDA study done for the Department of Defense. While we are always being warned not to keep old medicines laying around, these warnings are not generally valid for antibiotics (though there are exceptions - see the links below). Certain bio active substances, like vitamins, go bad rather quickly, and their shelf lives should be respected. Tetracycline can turn poisonous after its expiration date. Please read more about this by following the links below.
I am no doctor, and no expert on such things; but I have some links below directing you to the sites of people who are.
A good basic supply of antibiotics will set you back a couple hundred dollars; but such a supply will last for 20 years, and be invaluable if things ever get really bad. In a disaster or long term collapse, gold, silver, and precious gems will be entertaining trinkets, and money will have no value at all. Food, water, and shelter can be scavenged, scrounged, made, or begged, depending upon how intact the government might be. Bullets, drugs, batteries, and gasoline/oil will be valuable beyond measure, because such things are consumables, and without the grid they will be unavailable. Even in normal times, we don't consider it odd to keep a flashlight, a battery operated radio, and a few days worth of food around the house - just in case. Of them all, only bullets and drugs might actually save your life.
Good health, and good fishing. And remember, these are for aquarium use only, and any descriptions of any human applications read here were all made up or are figments of my Lyme addled imagination. I would never dream of actually doing such things, and would never ever recommend that anyone else do so. Such things are also against the law.
Before ordering anything for your fish, dog, cat, zombie, or whatever, read the first three pages linked to. The third one is by an MD.
http://theprepperpages.com/five-secrets-to-fish-antibiotics/
http://www.amazondoomsdayprepper.com/fish-antibiotics
http://www.doomandbloom.net/alternative-antibiotics-in-survival/
Lyme Specific
http://www.treatlyme.net/treat-lyme-book/kills-lyme-germs-a-brief-antibiotic-guide
http://www.cdc.gov/lyme/treatment/
http://wisconsinlymenetwork.org/
Places where your sick dog can get medicine (no humans allowed)
http://www.drsfostersmith.com
http://www.petsporium.com/antibiotics/
http://www.thomaslabs.com/category/209-antibiotics.aspx
http://fishantibiotics.net/
http://mydoghasfleas.xyz/flagyl