Health
Cruising can be both good and bad for your health. In a good way, it keeps you agile with climbing in and out of the dinghy, and scrambling around in all kinds of awkward positions to fix or reach things. You have to do a lot of walking around because you don’t usually have a car. And occasionally you have to get in the water to scrub the bottom.
But it can also have its drawbacks. Because you don’t have to work seriously at anything, or have any kind of schedule, you can party every day, all day if you want. You can sit on the boat on the computer, watch movies, or read all day. You can sleep as long as you like – all day if you want. When you do exert yourself, it can be in short bursts like hoisting up the mainsail or heaving heavy, jerry jugs or groceries aboard – good for heart attacks for us old people. You tend to walk around in the heat and the sun.
So there are certain things that you have to pay attention to. Things like trying to get some good aerobic exercise every day – we try to walk early in the morning before it gets too hot. We put sunscreen, hats and sunglasses on, and try not to party too much.
Whether you choose to get out of country medical insurance is totally up to you and your budget. But good medical and dental care is available all over the world, and in most countries it is vastly cheaper than in North America.
We have taken charge of our own health by keeping our own files and making our own appointments and getting our own blood tests and other tests done when we know we need to. It does not much matter which country we are in at the time. We just ask around the other cruisers, and there is always somebody who has a recommendation.
What to keep in your medical kit? You will undoubtedly be clipping out articles like I did as to what on earth to keep on hand for all the exotic diseases you are going to get, and all the surgery you will have to do at sea. These lists are good, and sometimes they are overwhelming!
We went on a ‘seminar’ put on by a couple of cruisers, who are both doctors. The idea was to have on hand a decent kit to cover most scenarios without costing an arm and a leg. Here is what they recommended:
I. Oral Antibiotics:
Be prepared by having at least one antibiotic from each category. Ask advice if necessary – try to get someone on the radio for advice. Choosing the right medication can make all the difference.
Category a) Skin Infections – have one of the following:
Cephalexin, Dicloxacillin, Flucloxacillin, Erythromycin or Augmentin
Category b) Respiratory Infections – lung, sinus, ear, nose, throat. Have one of the following:
Amoxicillin, Erythromycin, Doxycycline, Bactrim, Seprta, Augmentin, Cipro.
Category c) Urinary Tract – have one of the following:
Bactrim, Septra, Cipro, Augmentin, Nitrofurantoin
Category d) Mouth/Dental – have one of the following:
Erythromycin, Augmentin, Amoxacillin, Clindamycin
Note: If penicillin allergy – avoid Amoxicillin, Augmentin, Dicloxacillin, Flucloxacillin. If you have never had Bactrim or Septra, consider an alternative since allergy to these drugs is common.
If you want only one antibiotic on board, choose Augmentin. Although it is much stronger than what is needed in most cases, it will cover you for most types of infections.
This list is representative only. There are more antibiotics than we could possibly list, so you might have things on board as alternatives.
Augmentin = amoxicillin with clavulanate. Not the same as straight amoxicillin.
Bactrim & Septra = Trimethoprim/Sulfamethoxazole
Keflex = Cephalexin
II. Antibiotic Drops:
a) Eye – there are too many to name, but virtually any antibiotic eye drop is fine. If you don’t have any, consider getting a prescription for one. Make sure it doesn’t need to be refrigerated.
b) Ear – same as above. Often one bottle of antibiotic drops can be used for either eye or ear, saving you money to buy only one bottle.
III. Topical Creams:
a) Infection – Bactroban (mupirocin) is probably the best. Have a general antibiotic cream as well.
b) Burns – Silvadine or equivalent
c) Allergic Skin Reactions – Triamcinolone or equivalent cream. Over the counter cortisone cream is too weak to do much good.
d) Antifungal – Lamisil over the counter.
IV. Allergic reactions:
Oral medications – consider both Benadryl tablets (25-50 mg) over the counter, and Prednisone tablets (5-10 mg) prescription.
The epi-pen is one product that really should be disposed of after the shelf life indicated.
V. Nausea/Vomiting:
For suppositories, any of the following: Compazine, Phenergan, Tigan. Also highly recommended – prevent dehydration from getting severe.
VI. Pain:
Have something for moderate and severe pain.
Tylenol, Aspirin, Ibuprofen.
Mild pain – Codeine
Moderate pain – Hydrocodone or Oxycodone, or Tramadol
Injectibles for severe pain – Demerol, Morphine, Tramadol
VII. Sedation:
Valium 5-10 mg tablets
VIII. Fever:
Tylenol or Panadol – especially for Dengue Fever
Ibuprofen
IX. Diarrhea:
a) To control symptoms – Immodium or equivalent for mild cases, or Lomotil (prescription) for severe cases.
b) To treat bacterial cause – Cipro or Bactrim – treat only if necessary
c) To treat parasitic cause (giardia or amebic) – Flagyl (metronidazole). Consider stool analysis before treating for this.
X. Malaria Prophylaxis:
Consult current CDC (Center for Disease Control – Atlanta) website for updates and treatment guidelines – they change!
Use mosquito netting, clothing and insect repellent.
XI. Women’s health:
a) Vaginal yeast infections – over the counter meds/creams are fine. There are several different brands. Oral diflucan (prescription) is good but expensive.
b) Child bearing years – Consider bringing a home pregnancy test kit if this is relevant to your situation.
c) Pre-menopausal/Early menopausal years – excessive uterine bleeding can be a real emergency. Carry one package of birth control pills for use to stop bleeding until you can get other help. Take 1 pill 4 times a day until bleeding stops.
The above does not cover your First Aid kit. In addition to some of the gear listed above, the key ingredients that we have used, in our kit are:
Infection – iodine (the only thing to use for barnacle cuts in tropical waters), hydrogen peroxide and rubbing alcohol. Polysporin eye/ear drops and Polysporin cream.
Injury – The usual assortment of sterile gauze, adhesive tape, butterfly bandages, band aids. An eyewash cup and a bottle of contact lens saline solution has come in handy a few times. And those elastic bandages for sprains and bad knees.
Dental –Listerine, temporary filling material and a little metal packing tool for fillings that fall out.
We have made great use of a product called Efudix. This is a cream that you put on to kill off your pre-melanomas. It works by attacking only those cells that are dividing abnormally. If there are no bad cells, it doesn’t do anything. If there are bad cells there, it makes the area go all scabby and then it heals and peels off, revealing brand new skin underneath. Ed did his nose recently and I have done mine. Check with your doctor, but it is available in many places around the world over the counter. Careful though, it is the same chemical that they use in chemotherapy and is a poison – you are not supposed to treat an area more than the size of your palm, or it could start killing off your white blood cells! Be clear on how to use it before starting.
For malaria, we decided that we were going to be in malaria country for so long that we didn’t want to take anything because of the side effects. So we rigged the boat up well with mosquito netting and we did OK.
Before you go – check out your local Health Clinic and find out which vaccinations you need for the area you are planning to cruise. You may need Yellow Fever and Hepatitis shots, and others. For sure get your tetanus updated.
And, before you go – get your prescription medication filled as far out as you can get them to do it. When you get ‘out here’, check out the local pharmacies in the various different countries. In many cases, you can get your prescription meds over the counter at a fraction of the cost.