Challenge: Thinking Outside the Medical Box | Seizure, Perhaps Diabetic

[MermaidMuse]

Originally Posted by zeehag

i did not say to use an emergency room, but if ye have it , do use it.
sugar in the cheek between cheek and teeth in the case if loss of consciousness is a field remedy i was taught when i worked in a situation wherein we had no emergency room available. it DOES do the trick.
apparently you did not read my posts. please do that , then critique my answers. thankyou.
i gave FIELD answers for when there is no ambulance nor emergency room available. i gave the allegedly proper and accepted answers. i have worked for many many years outside the box and inside it as well.
honey is not always available nor is a swab always on hand. i always have sugar in my galley, as do most folks.

is nice to know about onion juice--didnt know that one. thankyou for that.

zeehag, I have read your posts entirely and apologize if my words sounded like a critique. That was not my intent.

I think much of what we are saying is the same but our differing dialects allowed our words to pass by each other without meeting.

I am in agreement about the method of application of a sugar containing substance in the mouth. I was using “swab” as a verb to mean using a tool to apply/wipe the honey or sugar inside the mouth, not that swab itself (noun) need be used. We try for under the tongue if possible because it absorbs faster from this location. During a seizure that would be more difficult so I would then try for inside the lip. The main reason for choosing inside the lip is to apply the honey/sugar where it is less likely to be accidentally inhaled. Cheek is certainly fine too. I have had faster results using honey over sugar if available. I am not contradicting your suggestion here.

The one or two drops of onion juice in the nostril can help to bring consciousness back into the body, thereby interrupting the seizure. In some ways this is similar to using "smelling salts" except for the onion juice, having the anticonvulsant qualities, is gentler on the body and does not cause the sharp withdrawal reflex that can occur with ammonium carbonate salts.

[MermaidMuse]

Originally Posted by avb3

What may be appropriate is if you can point to any peer reviewed studies that would substantiate the traditional/herbal theories.

As example, willow bark was used as a traditional remedy, and aspirin was developed using the acetylsalicylic acid present in willow bark. It is a case where the traditional was substantiated by scientific proof.

Most traditional/herbal remedies do not stand up to this rigorous process, but rely on folk-lore alone. In fact, most have been shown to have no more then a placebo effect, and many are downright dangerous, especially if they are used in place of allopathic treatments.

I did a search in the google scholar, and all I could find was references to traditional/herbal/folk remedies; no peer reviewed study was found that could speak to the effectiveness of your suggested treatment.

Onion juice may do no harm, but on the other hand, when dealing with emergencies, should we not rely on proven methods can assist, rather then spending time on ones that have no science backing them?

Peer reviewed by whom?
There is a lot of ghostwriting and selective result publication occurring in allopathic research which now casts doubt on many of those publications.

Would you accept articles/research published in Ayurvedic, Siddha, Unani or Chinese medical journals? Are you prepared to read articles that include the Sanskrit, Arabic and Chinese terminology amidst the English?

For example, if the peer reviewed article stated: "Akshepa is a separate disease, classified under Vatananatmaja Vyadhi as well as it has been found as a lakshana in different diseases like Apasmara, Apatanaka, Apatantraka, and so on, but it is mainly observed in Apasmara." and then discussed various treatments of akshepa in the same format, would it be of any use to you?

You and possibly others reading this forum might need me to explain that akshepa is the Ayurvedic medical term for convulsion, lakshana means signs, symptoms or characteristic features of a disease, apasmara is the Ayurvedic term for the condition most closely associated with epilepsy (of which there are four distinct types) and Vatananatmaja Vyadhi refers to a disease specifically caused by the Vata dosha. Vata dosha is the psycho-physiological functional principle of the body that relates to all movements and activities. Vata dosha is responsible for the flow of breath, the flow of blood, the elimination of wastes, expression of speech, the flow of thoughts in the mind, the movement of cytoplasm within a cell, the movement of the diaphragm and all muscles and limbs, the regulation of the nervous system and the stimulation of the intellect.

All of the traditional medical systems I mentioned are recognized by the World Health Organization (WHO) as complete medical systems. I do not consider allopathic medicine to be superior to traditional medical systems. Each medical systems has its strengths and weaknesses. We can use them together in an integrated manner. Allopathic iatrogenic disease (disease caused by physician or surgeon) is a leading cause of death in the US. Integrated health care could reduce that.

Traditional medicine systems have withstood the rigorous review of thousands of years of case history. It would be a great disservice to humanity to discount the holistic systems just because they do not fit the reductionist testing methods of allopathy.

The OP asked for commentary on what others would do in the given situation. I offered the onion juice as a possible way to restore consciousness if one's preferred method is not available.

It is doubtful that I would ever have valium in my medicine cabinet or medical kit either on land or at sea. I queried a few of my friends on this. They don't have valium on the boat either so use of valium would not have been an option for them either.

As for being a proven method, out in the field or bush, with nothing else available, onion juice has helped many recover from an immediate seizure. Further medical treatment would, of course, be necessary to prevent future occurrences. I offer the method as food for thought. I understand that not everyone will be comfortable with it.

[capngeo]

Mermaidmuse....
You seem to have some very good resources... are you a physician?

[osirissail]

Mermaidmuse: " I do not consider allopathic medicine to be superior to traditional medical systems."

"Although allopathic medicine was rejected as a term by mainstream physicians, it was adopted by alternative medicine advocates to refer pejoratively to conventional medicine." Interesting use of Indian Sanskrit terms to express your "contempt or distaste" (pejorative) for Western medicine.
- - I love studying different languages but find it difficult to understand "Akshepa is a separate disease, . . ." which translates to "Lima Beans." I don't like them either but don't consider them a disease.
- - Point is, the various medical systems used worldwide - Western, India, China, even American Indian and South American Indian (Amazonian) all have evolved to fit the needs of their populations. There is a lot of good aspects of each and a lot of less than good, even harmful, aspects of each. Using pejorative terms to describe Western Medicine diminishes your point that "Each medical systems has its strengths and weaknesses. We can use them together in an integrated manner."
- - Even Western medicine is not so biased. "Western medicine has ayurveda classified as a system of complementary and alternative medicine (CAM) that is used to complement, rather than replace, the treatment regimen and relationship that exists between a patient and their existing physician."

** My quoted phrases are from various Wikipedia explanations of the subject.**

[tartansail]

Back to the OP and the challenge, a few thoughts for the "typical" cruiser --

Many of us sail relatively shorthanded and with a family crew so knowing each other's medical history should be easy. However, it is critical. In this scenario, I wouldn't have taken this person offshore if I had known her history. Few of us have space or resources for someone who may not be able to carry his/her share of the work. The risks were too great that something bad would happen. Would I feel badly and be happy to take a terminally ill person for a coastwise trip? Absolutely. IMHO, going offshore with a high risk crew member of any sort is a form of poor seamanship.

It's good to identify one crew member as the medic. They don't need to be a medical person, but they can make sure the kit has what's needed, the crew histories are known and can be the point person if something bad happens. Otherwise, this falls to the skipper and a medical emergency requires other tasks for the skipper -- keeping the boat safe, planning any changes in course, communicating with outside resources, etc.

The Merck Manual is a great resource in any form. However, most of what is going to go wrong on passage is going to fall into: (1) Seasickness -- which can be debilitating for those so prone, (2) Trauma -- Broken bones, head trauma, lacerations (3) Infections, or (4) manifestations of pre-existing conditions (which is what happened in this scenario),

Seasickness -- Lots of threads on the subject. One of the meds I always take is rectal compazine. (Sheesh, I'm spending too much time talking about the back passage. People are gonna talk.) Not pretty, but very effective in severe situations.

Trauma -- Agree with CapnGeo on lots of wider bandages, stuff to absorb blood. Battens make good splints, though you need several for big bones. Super glue is a great alternative to sutures. However, you don't really need to bring the skin together most of the time. In fact, you'll have less prospect of infection if you dress most wounds open. The reason you get sutures in the ED has more to do with getting a good cosmetic result and faster healing than safety. Pain management is a big deal, especially if the injured person is going to be on board for a while. I take Percocet and pre-filled injectable morphine. I've never had to use either, but wouldn't hesitate if the need arose. You need an understanding MD to write the prescriptions (which you should bring with you), but they are out there.

Infections -- Zee had a good list. I tend to just bring Cipro and Keflex unless one of the crew has a penicillin allergy (which can cross react with Keflex). Then I bring Zithromax. I use the Keflex for skin and wound infections and Cipro for most other stuff.

Pre-existing conditions -- The PDR is great, but you don't need it if you have the crew bring the package insert for every one of their meds and keep them in labeled bottles in an identified location. The insert info is what's in the PDR anyway. Have the medic read the relevant sections of the Merck Manual or another resource before departure to have a basic idea of the complications of the conditions on board. It's usually only a few pages. If there are questions, Google (and CF) are your friends. They may not be available off shore.

Other -- I always stock a couple of epi-pens and Benadryl just because it would be a shame for a severe allergy to be fatal because they weren't there.

All the stuff you need (except the battens) fits easily into a mid-sized tool box. Label it and make sure everyone knows where it is as part of crew check-in.

If someone on board has a serious condition and you don't have SSB, consider renting a Sat phone and signing up in advance with a service that you can call if something happens. If that's not an option and the prospects of complications are significant, ask yourself if bringing that person (or going if it's you) is really the right choice.

[sailorgal]

Originally Posted by MermaidMuse

Traditional medicine systems have withstood the rigorous review of thousands of years of case history. It would be a great disservice to humanity to discount the holistic systems just because they do not fit the reductionist testing methods of allopathy.

The OP asked for commentary on what others would do in the given situation. I offered the onion juice as a possible way to restore consciousness if one's preferred method is not available.

It is doubtful that I would ever have valium in my medicine cabinet or medical kit either on land or at sea. I queried a few of my friends on this. They don't have valium on the boat either so use of valium would not have been an option for them either.

As for being a proven method, out in the field or bush, with nothing else available, onion juice has helped many recover from an immediate seizure. Further medical treatment would, of course, be necessary to prevent future occurrences. I offer the method as food for thought. I understand that not everyone will be comfortable with it.

Rigorous review of thousands of years of case history? What methods were used for this rigorous review? Traditional medicine, as it's called, was used because that's all there was at the time. I'd rather trust modern science with the ever increasing understanding of what actually causes disease to treat any medical problems I have.

Here's an interesting book comparing "traditional medicine" and modern medicine

Amazon.com: Trick or Treatment: The Undeniable Facts about Alternative Medicine (9780393337785): Edzard Ernst, Simon Singh: Books

As for valium, considering it's value in treatment for siezures, maybe it should be in everyone's medical kit on board. We have it on board.

This is a great thread and I'm adding to our list of items to include in our medical kit.

[MermaidMuse]

Originally Posted by osirissail

Mermaidmuse: " I do not consider allopathic medicine to be superior to traditional medical systems."

"Although allopathic medicine was rejected as a term by mainstream physicians, it was adopted by alternative medicine advocates to refer pejoratively to conventional medicine." Interesting use of Indian Sanskrit terms to express your "contempt or distaste" (pejorative) for Western medicine.
- - I love studying different languages but find it difficult to understand "Akshepa is a separate disease, . . ." which translates to "Lima Beans." I don't like them either but don't consider them a disease.
- - Point is, the various medical systems used worldwide - Western, India, China, even American Indian and South American Indian (Amazonian) all have evolved to fit the needs of their populations. There is a lot of good aspects of each and a lot of less than good, even harmful, aspects of each. Using pejorative terms to describe Western Medicine diminishes your point that "Each medical systems has its strengths and weaknesses. We can use them together in an integrated manner."
- - Even Western medicine is not so biased. "Western medicine has ayurveda classified as a system of complementary and alternative medicine (CAM) that is used to complement, rather than replace, the treatment regimen and relationship that exists between a patient and their existing physician."

** My quoted phrases are from various Wikipedia explanations of the subject.**

You are reading something into my post and making incorrect assumptions that I did not put out there. I was not aware that the term allopathic was considered a perjorative. I certainly did not and do not use the term with that intent.

In many countries, "western medicine" is also understood to include the European form of Naturopathy. I used the term allopathic to distinguish between the two. Many of the allopathic physicians that I work with have expressed frustration with the quality of information in their professional journals. I received the link to the Pharmalot article on ghost writing from an MD who routinely reads the Pharmalot site in conjunction with JAMA and similar publications. He's very frustrated with the "peer reviewed" information available there. This is why I ask "peer reviewed by whom?" if someone makes that request of me. Different people value different sets of peer reviews.

BTW, I think you find that Akshepa does not mean "lima bean" in this article from the AYU journal.

Yes, various medical systems evolved to meet the needs of their populations. Populations have migrated around the globe. Populations have mixed. There is no one medicine that fits all people and all situations. Even in the US there are many who use traditional medicine for their primary care even though they must pay out of pocket or travel for it.
I am perplexed as to why you interpret a request for integrated medicine as biased *and* I do not want to derail this thread by getting into a debate between medical systems. I leave this discussion. ciao.

[MermaidMuse]

Originally Posted by capngeo

Mermaidmuse....
You seem to have some very good resources... are you a physician?

That would depend on your definition of physician and country of context.

Inside the US I practice my profession with a very limited scope. Outside the US it varies by country. We traveled much as I was growing up. From that I also have personal experience with field medicine that is beyond the scope of my formal training. It would appear that even simple aspects of my experience is too far outside the box for many on this forum.

It's a good thing we did not get into any discussions on using maggots to keep a wound clean when there are no supplies and many days will go by before a bandage can be changed.

Thank you for an interesting and illuminating thread.

I'll go back to lurking now.

[avb3]

Originally Posted by MermaidMuse

That would depend on your definition of physician and country of context.

Most people would consider a physcian one who has passed the appropriate university education in his/her jurisdiction and is accreditied to practise. Any other attempt at a definition is suspect to being obfuscation.

It's a good thing we did not get into any discussions on using maggots to keep a wound clean when there are no supplies and many days will go by before a bandage can be changed.

Not any old maggot will do, although there are numerous studies that indicate the there is an efficacy of use of blowfly maggots. That same efficacy may not exist with housefly maggots (I am surmising, as I don't know). Here is one that relates to maggots. There are a number of other ones; this is from a credible agency and website.

[zeehag]

leaches also are back in vogue--for anti coagulation effects.....

[avb3]

Originally Posted by zeehag

leaches also are back in vogue--for anti coagulation effects.....

I was aware of that.

My mother used to tell the story of how she was in hospital in Germany after the war for many months due to some problem in her veins in her legs (not sure the medical term).

My uncle, an internist, used leeches to treat her. She hated them because I guess they got to be quiet large, but the treatment eventually worked.

[DeepFrz]

Its really to bad but a thread with so much good material has been almost obfuscated to death.

[osirissail]

Originally Posted by DeepFrz

Its really to bad but a thread with so much good material has been almost obfuscated to death.

I quite agree, but the value of this Thread started and ended with CapnGeo and his narrative. After that there were posts about good sources of information and materials that might be useful in the scenario presented. Then, as almost always happens on CF, digressions or departures from the main subject took over. But there was still valuable bits of information to be gleamed from those subsequent posts.
- - IMHO, in any public discussion such as CF forums there is a large audience of non-technical type folks with an honest interest in understanding what the heck is being discussed. Since language is the only vehicle we have to communicate bits of information, wisdom or wit, I for one, would suggest avoiding using exotic, foreign or highly technical terms that few if any of the people reading the forum can understand.
- - For example, the Indian Sanskrit terms for their alternative medical system and even words like "obfuscation" sound impressive but if they are not carefully researched by the user as to their meanings, there is the chance of scuttling your whole intended point or contribution to the discussion. Some of us do know what they mean and/or look them up.
- - Bottom line, for a thread such as this very valuable one to reach out to the majority of readers, it would be best to use commonly understood language, or if technical/exotic language is called for - provide a definition or a way we can understand what the heck you are talking about.

[atoll]

as a doctor,who was crew on one of our many voyages said,"if you need to treat someone in an emergency,out of date medicines are probably better than no medicine,in an emergency"

[zeehag]

i found meds are usually good for a little over a year after expiry date....i use some for longer.. doesnt yet kill me or make me more ill. after about 1 1/2 yrs,i find some lose a little strength, but are still better than nothing.