Health Tips from Sockdolanger

Karen Sullivan and Jim Heumann

The following is a note from former students Karen and Jim written from Nuka Hiva in French Polynesia. They have just completed the passage from Mexico aboard their Pacific SeaCraft Dana 24 Sockdolanger. Their entertaining and informative blog can be accessed here: http://karenandjimsexcellentadventure.blogspot.com/ .

Hi Jeff!
Thanks for your note.  As a result of taking your class we have remained disgustingly healthy and hydrated, so we have nothing major to offer as a case study.  However, 37 days at sea does get noticed by the body, and we'd reiterate or amplify a few things you taught.  You are welcome to share it with other classes. 
 
1)  Rib cage injuries can occur even without being thrown around.  Mine felt chronically bruised from the centrifugal force of being pressed into the cockpit coaming every few seconds as the boat rolled, over days and weeks.  Eventually even a cushioned, curved coaming will hurt.   The G-forces on some rolls were strong enough to pop a vertebrae, and I was surprised to feel that.  You have to start thinking about keeping your ribs unbruised early in a voyage, because once they ache, every move makes it worse.  On our sail down the Washington-Oregon-Northern California coast I learned that the hard way.
 
2)  Staying hydrated also helps keep the bowels moving, but after a long time even that's not enough.  Exercise on a wildly moving boat is mostly isotonic gripping and bracing, and it really does show up in upper body muscles after a long voyage.  But unless you can do squats or some other lower body exercise, you will likely have the constipation problem. Plus, it's hot sailing in the tropics, and spending any time in the sweatbox known as the head is one of the least pleasant parts of the day.  Jim suffered the results of several days of unpleasantness.  Suppositories finally solved it, but we weren't sure even they would work at first.  I think we just caught it in time.
 
3)  Keeping your skin clean is very difficult in the tropics.  A daily wipe-down with a wet paper towel or baby wipes helps a lot, if fresh water is limited.  Any cuts in the skin, no matter how small (even if it's a scratched bug bite) must be taken seriously.  We know of one boat where a man went for a walk ashore and fell over a rock, lightly cutting his hand.  It got infected immediately and became systemic, sending him to the local infirmary.  He's now on a plane home.  
 
4)  Back problems happen when all hell breaks loose and you're trying to get the anchor up or a sail reefed without awareness of your body's needs.  Some friends brought one of those warehouse-worker back braces and were glad they did.  I wish we'd thought of a prescription for muscle relaxants, as my back went out for a week on arrival in the Marquesas, and was very stiff and painful.
 
5)  Anyone who obtains the kind of medical kit needed and described in your course will likely, if you declare everything, run into legal questions in Mexico, because they have rules that appear to be enforced quite arbitrarily.  One rule says you can bring your own prescription drugs in, but another says you can only get Rx drugs from a Mexican physician.  We checked the rules for declaring and importing your US-prescribed drugs, and it sounds like a nightmare.  Basically, they'd seize them.  A boat crew we know that waited to get Rx drugs in Mexico received only the most basic antibiotics, and no pain meds.  Another boat (friends we met in your course) did as we did, and we had discussed it at length with them in San Diego.  Our serious meds are concealed in a special locker to keep them out of easy reach, and we have a packet atop them that contains all the prescriptions, receipts, the certificate from your course, ship's medical inventory, plus that very important page printout from the Federal Register.  
 
All of the lesser meds plus wound care and other first aid materials are in three canvas bags in an easy to reach locker. We've been questioned twice about "drugs," once in Mexico upon entering the country, and again recently by French Customs in Polynesia.  We interpreted that to these officials, the word "drugs" meant illegal ones, and responded that outside the prescriptions in our ship's medical kit there were no other drugs aboard.  French Polynesia, where we are now, seems much more relaxed on entry rules, except for one thing:  If you bring in more than the allowed amount of alcohol and lie about it, they can fine you thousands of dollars and tell you to leave the country. They're all over the alcohol importation issue, but don't seem to care about ship's medical kits. It's a fine line to walk with a medical kit of the sort you need for world voyaging, but we have not met or heard of one cruising boat who has had any trouble over their medical kit.  
 
6)  Those apps for iPods, especially Medscape, Epocrates and Diagnosaurus, are invaluable.  I also like "Organs:  Anatomy 3-D."  It might be especially good in a case where language is a problem.  Epocrates and Medscape are is good for checking drug interactions, which I recently did for a friend who was prescribed by the local infirmary a round of drugs with instructions in French, to treat her husband's concurrent back pain, diarrhea, and a sea urchin puncture on his foot.  What I learned was that none of the names of these drugs or their generics were listed in any of my iPod apps or other lists, perhaps because they are called different names in other countries?  That was a surprise.  Two books by Kathy Parsons, called French for Cruisers and Spanish for Cruisers, have chapters devoted to describing medical issues to doctors in person and over the radio.
 
We can't adequately express our appreciation of the course, the energetic and engaging way you taught it, and the confidence (but not overconfidence) it gave us to go voyaging without the fear of being unable to recognize when something is a serious problem or not, as well as the knowledge of what can be done on a boat to treat it.  You rock!
 
Best,
Karen Sullivan and Jim Heumann
Aboard S/V Sockdolager in Nuku Hiva, French Polynesia
http://karenandjimsexcellentadventure.blogspot.com/