Medical Issues While Cruising

[ozdigennaro]

Great idea. I'll buy a copy. Be sure to publish an e-book for us paperphobics.
This may be obvious, but a good start is to read a few books about Wilderness First Responder.
It's helpful to set limits: "I'll handle things when we are one day from help." OR "I'll handle things when we are two weeks from help."
We're in an age when really good remote help can be provided.
Don't forget the jellyfish stings!

[DeepCut]

Great idea.

[alansmith]

Doc, can you cover the more outdated medications and remedies for sea sickness, jelly fish stings, stepping on sea urchins and have needles stuck in foot, food poisoning, and the like?

Let us know when you publish. Think you got a built in crowd right here.

[s/v Moondancer]

Many thanks for the excellent feed-back. It appears that the 'book' needs to be in traditional and modern electronic format.

What off-shore insurance companies do people use? Any stories of insurance successes or failures?

[nigelmercier]

Sounds like a good project. I do proof-reading in my spare time, very reasonable rates. For books I'm interested in, I do it for a signed copy.

[a64pilot]

Originally Posted by lesterbutch

I think the similarity ends at "being away".

Pretty much, but depending on where your sailing of course, it's one of the few activities that you are really days or maybe even weeks away from medical care, no matter how bad you need it.

Would be interesting to know though what is done medically to prepare for long duration space flight, dental check ups and the like.

I've had two bouts of Diverticulitis in my life, and I think somehow or another I'm going to try to travel with an effective antibiotic if possible.
My Father when alive and I was doing things in Southwest Asia that could have made me a long term guest of someone.
He gave me two bottles of antibiotics, apparently two different types will cover most anything.
Is there gram negative and gram positive bacteria? Was that what it was? Been a long time ago memory isn't what it was

[s/v Moondancer]

Pilot,

The medical preparations for going cruising will be well covered including medications for predictable problems. The best antibiotic combinations will also be covered for both gram negative and gram positive organisms.

The answer for diverticulitis comes from:

emedicine.medscape.com/article/173388-treatment


"One typical oral antibiotic regimen is a combination of ciprofloxacin (or trimethoprim-sulfamethoxazole) and metronidazole. Moxifloxacin is appropriate monotherapy for outpatient treatment of uncomplicated diverticulitis. Amoxicillin/clavulanic acid monotherapy is acceptable as well."

[In Training]

We will be interested in the prescription options while cruising. Husband has fibermyalgea (spelling probably wrong), and other issues.

[a64pilot]

Thank you,
I wan't expecting an answer, actually I'm afraid you may get many questions.

I await the book

[Shrew]

Anyone ever consider 'Wilderness First Responder' training?

Admittedly there is alot which addresses 'transportation' and 'evacuation' which might not apply. (You're probably not going to be carrying someone 10 miles out of the backcountry) However it is way more comprehensive than even advanced First Aid.

[s/v Moondancer]

I would like to thank everyone for their contributions...Thay have all been valuable in shaping the final 'book.'

I think my biggest challenge will be with modern formats, having spent the last 9 years cruising on boats I am way behind on electronic formats!

I still need examples of the use of medical insurance, good and bad.

Phil

[Taichungman]

You might include a section on "Mycobacterium marinum infections."
In Feb. 2014 I sailed from Panama to the Galapagos Islands. I was crewing on a Kurt Hughes 65' Cat. and about 5 miles off our entry Port the Captain decides that we should clean the hulls. So in the water we go with our scrapers and pads and begin the job which took about two hours. There is nothing to hold on to so we had to drift with the boat and occasionally I would have my knees dragging along the hull. Anyway we got the job done and went into port and later when we cleared in they did take a look to make sure we had a clean hull, It's a big deal down there in the Islands.
Later in the evening when I was showering (bucket of water over my head) I noticed I had two scratches on my right knee and two on my left arm. No big deal; I'm a big tough sailor. Well, about a week later the little scratches had little blisters on them, so I backed off a little and put some medicine on them. They kept getting worse and after three weeks sailing around the islands we were ready to jump off to the Marquesas but I had a close friend die in the States and had to leave and that's another story.
Anyway, I got back to the States and the little scratches now had turned into bigger sores that wouldn't heal. Actually the ones on my arm did heal some and looked better but the knee was worse. I'm a veteran so went to the VA hospital. They looked at it and said, "hey that's looks pretty bad." Gave me some antibiotics to take and bandaged it up, this was about a month after it happened. I stayed in the States for another month and it didn't get any better and they gave me more antibiotics.
I live in Taiwan so it was time to go home from my sailing adventure. When I got home I went to the doctor and they said, " hey that looks pretty bad" in Chinese of course and gave me more antibiotics.
OK, to make a long story shorter....I took antibiotics and went to 5 different doctors for 8 months and telling them the same story before I found one who told me that I have an Mycobacterium marinum infections. Which the doc could only tell me after he took a sample and sent it to a lab. They doubled up on the antibiotics and my stomach was getting all chewed up because of it. I finally said enough as the two sores on my knee were an inch long, gaping and bloody. I went to the hospital and over a two month period they surgically removed all the infected skin, meat, etc. and sewed it up. They had to do one at a time because they were so close together.
Lots of people and doctors are not familiar with this infection so I would suggest at the minimum you put info about it where people could protect themselves from getting it in the first place. In other words be careful around seawater with barnacles and such. By the way the boat originally came from South Florida where I found out later that breeds this kind of infection. A common name for this is "Fish Tank Infection"
Sorry, I didn't mean to write a book.

[mikereed100]

Great post and a good reminder to all of us to clean any wounds we get in the water well. It's a lot easier to prevent infection than to cure it. I'm sure the good doctor will include an entire chapter on water-borne infections. There are a lot of nasty players out there in addition to M. marinum including Pseudomonas and Vibrio.

By the way, your forum name brought back fond (and not so fond!) memories of being holed up in Taichung several years ago, tied to an old coal barge, waiting for a weather window to continue north. Apparently we were the first yacht to visit the commercial port and they had no idea what to do with us, but the coasties and water police made us feel very welcome.

[Taichungman]

Originally Posted by mikereed100

Great post and a good reminder to all of us to clean any wounds we get in the water well. It's a lot easier to prevent infection than to cure it. I'm sure the good doctor will include an entire chapter on water-borne infections. There are a lot of nasty players out there in addition to M. marinum including Pseudomonas and Vibrio.

By the way, your forum name brought back fond (and not so fond!) memories of being holed up in Taichung several years ago, tied to an old coal barge, waiting for a weather window to continue north. Apparently we were the first yacht to visit the commercial port and they had no idea what to do with us, but the coasties and water police made us feel very welcome.

You were probably the last to visit there also....can't even imagine...There are not to many private sailors in this neck of the woods. And, not a lot to see in the Taiwan Strait.....So, I bow to you....as you must be a great adventurer to go there in the first place.

I crew every couple of years or so just to get it out of my system. Next month I'm going to CT South Africa to help bring a St Francis 50 up to Annapolis for the USA boat show in Oct. I haven't told my wife yet..I think I'll wait until about a week before I go; I won't have to get chewed on to long that way. I'll check out the blog....

[mikereed100]

Originally Posted by Taichungman

You were probably the last to visit there also....can't even imagine...There are not to many private sailors in this neck of the woods. And, not a lot to see in the Taiwan Strait.....So, I bow to you....as you must be a great adventurer to go there in the first place.

Yeah, we were aiming for Ishigaki and got sucked into the straight by wind and current, then had to hide from the weather. We were something of a novelty and the local fishermen would go well out of their way to come check us out and take pictures. When we left Taichung early in the morning, the coasties drove 30 miles north to find us just to wave goodbye. Wonderful folks!