During a natural disaster, not having your medications or assistive devices adds to physical and emotional stress, which can trigger arthritis flares and leave you vulnerable to injury and infection.
“High stress levels make rheumatic conditions worse; having an established emergency plan can only reduce stress,” says Jennifer Hootman, PhD, an epidemiologist in the Arthritis Program at the Centers for Disease Control and Prevention in Atlanta, Georgia. Registered nurse Victoria Ruffing, director of nursing and patient education at the Johns Hopkins Arthritis Center in Baltimore, MD, also stresses the need to have a plan for your medications – and awareness of the potential dangers for people with arthritis of the storm’s aftermath.
“Contaminated water, debris, and other post-hurricane conditions mean environments are ripe for infection and injury,” she says. “People should be on the alert for these and, if they pick up a bacterial or viral infection or have a wound that’s not healing well, they should seek medical care as soon as possible. This will probably mean going to an emergency department, but they should not put off seeking care – in disaster conditions medical problems can get worse very quickly.”
With Hurricane Irma due to make landfall this weekend, there is still time for you to prepare for the storm and safeguard your health. The Federal Emergency Management Agency (FEMA) and other organizations have general advice for preparing your home for the storm and evacuating.
Everyone living with arthritis and in the potential path of the storm should:
- Create a support network. Contact family, friends and others who can assist you during an emergency, and share your disaster plans with them – including your likely route and destination if you must evacuate – so they will know where and how to locate you. Make sure a contact has an extra key to your home and knows your medical needs and where you keep your emergency supplies.
- If possible, ask family or friends outside the storm’s path if you can stay with them if you need to evacuate or call ahead to reserve a hotel room. Infections can spread rapidly in crowded emergency shelters and some arthritis medications increase your risk for picking up a viral or bacterial illness.
- Pack a “go-bag,” an emergency kit you can take with you if you evacuate. In addition to the basics, pack your assistive devices; a two- to four-week supply of your medicines (or as much as you can access); antibacterial wipes or sanitizer gel; special foods; batteries or electrical charging for assistive devices; insurance information, Medicare cards and other important personal documents; and a list of your medications and dosages and emergency contacts including numbers for your doctor, pharmacy and any specialty pharmacies. Double bag all items in sealed plastic bags or containers.
- Prepare a waterproof cooler or insulated bag for any medications that need refrigeration. Use freezable gel packs for coolers; you can also fill Ziploc bags with water and freeze them for later use.
- Keep auto injectors and syringes of medications that don’t need refrigeration in their cartons or a bag to protect them from direct light.
- Wear medical alert tags or bracelets if you have them.
- Check with your doctor and pharmacist to get any needed prescriptions or refills and to ask for their recommendations for what to do should you be stuck out of town for a time and need medical care or additional medications. Under Florida law, health insurers must waive time restrictions on medication refills in counties under a hurricane warning issued by the National Weather Service or that is declared to be in a state of emergency.
- Contact your city or county government’s emergency management office if your arthritis is disabling. Many local offices keep lists of people with disabilities so they can be helped quickly in an emergency. If you’re in Florida, sign up with the Florida Special Needs Registry, which coordinates with local emergency management agencies in the state to provide assistance to people with special needs and their information to first responders during disasters.
- Fill your gas tank and keep your cell phone fully charged so you’re ready to leave immediately if you need to evacuate.
- In the 24 hours before the storm, check local media outlets every 30 minutes to get the latest weather updates and emergency instructions. You can also tune into NOAA Weather Radio, a nationwide network of radio stations broadcasting continuous weather information directly from the nearest National Weather Service office, for emergency updates.
- Download FEMA’s app, which provides maps of open shelters and recovery centers, disaster survival tips, and weather alerts from the National Weather Service.
If you’re evacuating:
- If you’re evacuating through Florida, use Florida’s 511 Traveler Information System to get evacuation route updates, important alerts, emergency information, traffic updates, and more.
- If you must go to a shelter and need special assistance, explain your needs when you arrive and confirm the shelter can accommodate you. Most Florida counties have Special Needs Shelters for those who need assistance with daily activities.
- Be aware that public shelters will accept service animals, but many will not allow pets. Plan ahead for your pets, so you won’t have the added stress of having to leave them behind. The Department of Homeland Security provides more details on evacuating your pets safely.
- If your arthritis symptoms begin to flare or you pick up an infection, seek medical care as soon as possible. If you have a fever, an open wound or a significant flare, try to reach a hospital emergency department.
- Your rheumatologist’s office may be closed for days or weeks. If you’re away from home, check the Arthritis Foundation’s Resource Finder to locate a specialist where you’re staying. If your medications are mailed to you, contact your pharmacy or the drug’s manufacturer to provide an address to which they can mail your medications.
If you’re staying home:
- Gather all the items you’ll need in one room so you’ll have easy access to your medications and devices, as well as the basics like food, water, a first aid kit, cleaning supplies like wipes, a flashlight and batteries.
- Turn your fridge and freezer on the coldest settings that will not freeze your medications (which would make them ineffective) so if you do lose power your medications and food will stay cold longer.
- If your medication must be kept cold and has been at room temperature for more than 24 hours, don’t use it. Exceptions are adalimumab (Humira) and etanercept (Enbrel), which have been tested out of the refrigerator; they are good up to 14 days without refrigeration as long as they have been kept at a temperature of 77 F or lower.
Author: Emily Delzell for the Arthritis Foundation