Medicine Chest

[InTheDish]

We are getting ready to take Carly to the Bahamas for the winter.

I am meeting with my Doctor to put together the list of prescriptions I should have aboard and am looking for advice.

My Med School daughter is putting an antibiotic vs. infection grid together to get the basics needed.

I have talked to Dr. Tom about Lidocaine for stitching and /or stapling various wounds. He is giving me an ampule of injectable Epinephrine and some Prednisone for allergic reactions from random stings and bites.

Various painkillers, don't know that we'll go so far as injectable morphine...if someone is that badly injured we would call for rescue.

I have a pretty stout first aid kit with splints, wraps, ice packs, basic dentistry stuff, and other gear but wonder if I am missing anything that will come back to haunt me down the line.

Have I skipped anything obvious?

Thanks,

Rick

"All of us are dumber than any single one of us!"- Don T. 2003

[Vasco]

You will find the cruising community very helpful in an emergency. Cruising doctors and nurses. Quite a few boats have well stocked medicine chests And some settlements have clinics and prescription drugs. Georgetown now has a hospital and doctor. What you should really have is some sort of evacuation insurance.

[Sea Life]

Before we left on our multi year trip thru central and South America, and Caribbean, I made a huge list of everything I thought I needed based on others recommendations. Only to find out I couldn’t afford it. 2 1/2 years later, I haven’t needed much and most would be expiring. Lucky....maybe, resourceful.....definitely. When my finger was torn thru completely in San Blas islands of Panama, it was resolved. A fellow cruiser lost part of his finger in a wind gen, also resolved. This is in an area without BASRA etc. and Days away from facilities. In the Bahamas, you may be a day at most from an airstrip and a few hours from there to Fla.

We also met Drs, RNs, etc. I think it’s really a matter of convenience to have onboard or have to seek help.

Have your trauma stuff, cipro, amoxicillin, some pain meds, but unless you are going for years, I personally wouldn’t spend the money. It will all expire before you need it.

Side note: if anyone has a prostate issue and plans to take stugeron or similar, or has kidney stones, it may not hurt to have a self catheter on board. Don’t ask....

[scarlet]

I'm going to subscribe to this post to see what folks say (for my future ocean crossing voyages, etc).. but my first reaction is.. Isn't it a bit overkill? Depending on your departure city, you have a long day crossing to get to the bahama's.. then you are near doctors, hospitals, dentists, etc. It's not a 3rd world country. I'm wondering why the massive preparation, when you will have access to all you need. I'm thinking a basic first aid kit with bandages, medication, ointments, etc would be more than adequate.

Am I off base here?

[Sea Life]

I would spend the money on a safety at sea or back country medical class before I spent it elsewhere. Learn about how closing a dirty wound will kill faster then someone bleeding for days with a packed wound changing dressings etc.

Also super glue closes skin better then stiches or staples, with less scaring. Again...don’t ask

[InTheDish]

I just love this place, I ask about medicines and am told that my thinking is all wrong!

This year in the Bahamas is the start of what I hope to be a circumnavigation. I know about closing dirty wounds, I think my fellow MENSA members would put my I.Q at least in the high double digits.

It is my intention to be as self sufficient as possible as I make my way. I am also, due to my own age and that of my potential guests, having an AED aboard.

I have been quite fortunate in my life and a few expiring prescriptions is a trifle in the grander scheme.

Life raft, 3 EPIRBS, quality dink should allow me to keep my head above water until help arrives.

I have been sailing for 50+ years and have a well found boat and the knowledge to sail her. (I even have a drogue!)

Other than sailing and first aid classes and being in an anchorage with Physicians...have I missed anything obvious?

Rick

PS- We even have some super glue.

[Vasco]

You asked about the Bahamas for the winter. For a winter in the Bahamas your thinking is all wrong. Have a pleasant winter.

[s/v Moondancer]

Repatriation insurance for medical problems is more important than a massive medicine chest. We have used DAN insurance twice for medical evacuations of friends and we insist that all crew have DAN repatriation insurance.

I have organized 3 medical evacuations from the Caribbean and still have a lot of out of date antibiotics on board.

If you have Medicare there are supplementals that provide up to $50,000 in out of the country medical insurance.

Phil MD

[Sea Life]

If finances aren’t an issue, by all means, stock up. My point was it may be useless if you don’t know how to use it. Or if you are the one needing care, someone onboard doesn’t. Crossing an ocean is different then wintering in the Bahamas. Maybe change the title of the post. There is also a huge difference between a first aid/cpr class and an advanced wilderness/maritime medical class. At least have the appropriate medical guides onboard and maybe read ahead of time if you are worried about such things.

FWIW, all of our medical issues, accidents, etc. have always occured at anchor, spearfishing, partying, etc. never on passage. All of the fellow cruisers I have met would mostly fall into that statistic.

Maybe look into a “sat phone” doctor service. I have only read about such things though.

[Seaworthy Lass]

Originally Posted by InTheDish

Have I skipped anything obvious?

You have completely skipped anything that can deal with eye and ear problems.

Unit dose tubes of saline are a bare minimum. Ocular antibiotics can double up for aural use.

A simple syringe is handy for blocked ears that can cause problems with diving

SWL

[InTheDish]

Phil MD,

I am very well insured.

Sorry about your expired antibiotics. I believe the DOD did an efficacy test on outdated AB's and found that other than tetracycline which turns toxic most are still good after their use by date.

I'm on the hard now and the results are on the East Coast of Florida aboard the boat, which is being checked from stem to stern for any potential problems.

Best,

Belt AND Suspenders Rick

[InTheDish]

Seaworthy,

Good points! I have had to resort to just using Neosporin for an eye infection my son got while we were back country fly fishing a number of years ago. Poor kid got a cinder in his eye and it cascaded. The tough guy insisted we hike out.

[InTheDish]

Sea Life,

What shall I change it to?

B&S Rick

EDIT- Dr Tom and I are good friends, I can reach him on his cell pretty much all the time.

DOUBLE EDIT- I am being told that hanging around on the computer instead of taking a walk with my bride is another example of not having my thinking right. I look forward to continuing this chat later.

[dannc]

Regarding drug's expiration date, https://www.health.harvard.edu/stayi...-mean-anything

It turns out that the expiration date on a drug does stand for something, but probably not what you think it does. Since a law was passed in 1979, drug manufacturers are required to stamp an expiration date on their products. This is the date at which the manufacturer can still guarantee the full potency and safety of the drug.

Most of what is known about drug expiration dates comes from a study conducted by the Food and Drug Administration at the request of the military. With a large and expensive stockpile of drugs, the military faced tossing out and replacing its drugs every few years. What they found from the study is 90% of more than 100 drugs, both prescription and over-the-counter, were perfectly good to use even 15 years after the expiration date.

So the expiration date doesn't really indicate a point at which the medication is no longer effective or has become unsafe to use. Medical authorities state if expired medicine is safe to take, even those that expired years ago. A rare exception to this may be tetracycline, but the report on this is controversial among researchers. It's true the effectiveness of a drug may decrease over time, but much of the original potency still remains even a decade after the expiration date. Excluding nitroglycerin, insulin, and liquid antibiotics, most medications are as long-lasting as the ones tested by the military. Placing a medication in a cool place, such as a refrigerator, will help a drug remain potent for many years.

The FDA says to toss expired medicines.

I know what I do....

Later,
Dan

[Sea Life]

Like vasco suggests perhaps: medical supplies for circumnavigation

Only because it seems you may get alot of responses as above. Particularly as the thread gets longer and people don’t read the whole thing.