Medical Offshore--The Case of Andy Schwenk

[Christian Williams]

Andy has more than 50 sails to Hawaii. That didn't spare him the unexpected. Flesh-eating bacteria, anyone?

I recall the concern of a doctor friend on Kauai, as I prepared to sail home. The usual leg wounds we all suffer on a long passage. I wondered at his worry as he loaded me up with antibiotics. Jeez.

Modern times may seem to take the adventure out, but the resources the USCG has to save our butts remains astonishing. And their determination.

September 2022 - Latitude38

www.latitude38.com

 

[HerbertFriedman]

I saw Andy at our YC this evening, in a wheel chair with his leg completely bandaged but smiling and in very good spirits.

 

[Prairie Schooner]

I have a tendency to be cavalier about nicks and scrapes. Those photos are certainly sobering. Major pucker factor. Time to augment the first aid kit.

 

[southofvictor]

Anyone ever use a service like this to put together a kit rather than just friendly doctors at home?

Rx Kit + High Altitude | TravelMed

Going on a high altitude climb? Rainer, Denali, Shasta, Whitney, Everest... don't go without your Rx Kit of symptomatic and high altitude prevention medications that could save your climb from being ruined by minor illness.

www.travelmed.us

 

[toddster]

Anyone ever use a service like this to put together a kit rather than just friendly doctors at home?

Rx Kit + High Altitude | TravelMed

Going on a high altitude climb? Rainer, Denali, Shasta, Whitney, Everest... don't go without your Rx Kit of symptomatic and high altitude prevention medications that could save your climb from being ruined by minor illness.

www.travelmed.us

Interesting. Looks like a reasonably good value. I've used gray-market off-shore web sites to order in antibiotics from India, et al. but it's a bit uncertain and can take a long time. I like to keep two courses on hand, while it looks like this kit includes only one. By stockpiling, one tends to accumulate "expired" drugs, but in most cases, they're actually still good. (There has been limited research on this. IIRC, that's one reason to go with doxycycline over some of the other tetracyclines - it doesn't accumulate potentially toxic breakdown products.)

However, in the case of fast-moving necrotizing infections, oral antibiotics might not be enough. Keeping injectables on hand (and using them) may be a bit beyond most of us.

Last year, I ended up with cellulitis after a boating mishap and used one of the telemedicine web sites to get a prescription. (My stash had run out and I didn't have time to try to import any.) It went pretty well. Cost $16 and took a couple of hours to sign up and get on-line with (hopefully) a doctor. Vs a week and $1000 to see someone locally.

(I still don't know exactly what happened. Got back from a "sporty" sail and my ankle was deeply "bone" bruised. And it ended up being infected.)

 

[Sean Engle]

on Kauai,

I had a former client of mine who lived on Oahu who got nicked on the beach, got a flesh-eating bacterial infection that nearly killed him.

So when we were out on Kauai in 2019, I made it a point to purchase ReefRunner booties to wear in the surf. My wife thought I was going overboard insisting on it...but once she saw the soft, deep sand with the bits of shells in it and all the exposed lava, etc. she changed her mind.

//sse

 

[nquigley]

Anyone ever use a service like this to put together a kit rather than just friendly doctors at home?

Rx Kit + High Altitude | TravelMed

Going on a high altitude climb? Rainer, Denali, Shasta, Whitney, Everest... don't go without your Rx Kit of symptomatic and high altitude prevention medications that could save your climb from being ruined by minor illness.

www.travelmed.us

Luckily, one of my sons is an ED doc - Before I push off, I'll be hitting him up for a gift of a comprehensive medicine-at-sea kit, incl any prescription-only things (e.g., antibiotics, and very strong pain medicine.(

 

[southofvictor]

Hawaii - what’s up with that place!?! I got an infection on Maui a few years ago that sent red streaks up my leg. Spent a day and a half getting IV antibiotics just so they’d let me fly home, then another course when back. Makes me love the high cold desert.

 

[toddster]

Don't forget that the seasickness meds that the rest of the world "enjoy" are prescription only (or not available at all) in the USA. (Though somehow, often available on eBay...)

Re: Pain medicine. There's some evidence that mixing acetaminophen and ibuprofen is just as effective as common pain pills and a whole lot less legally problematic. e.g.

 

[Tin Kicker]

Working around airplane wreckage meant constantly getting cuts & scrapes. I got the smallest knick at the base of my thumb one evening when using a brand new razor knife blade and put on a band-aid. Didn't think much of it, went to bed, and woke up the next morning with a bright red line right up to the elbow and had to go to the ER. I've tried to wash knicks and put on antiseptic right away ever since.

Something else to be aware of as we age is how commonly we "ahem" mature types get detached retinas. I started getting "floaters" in my left eye on a Friday going into Christmas week a few years back and didn't think much of it till the next day. Went to the regular doc and he sent me to have laser surgery less than 2 hours after. Turns out once there is a minor tear, the floaters are actually blood released into the vitreous fluid, and the fluid gets under the lining in the back of the eyeball. The lining will just keep lifting off the inner surface until you're blind and there's no fixing it at that point. Floaters are nothing to dismiss casually.

 

[toddster]

Changed my mind on the value of the above-mentioned Rx kit. Apparently, the price is only for the consultation and a prescription. You still have to buy the kit on your own. Price not disclosed.

FWIW, I called them up and the full cost for the basic kit is $560. Appears to me to be several times the actual retail cost of the contents.

 

[Bolo]

Flesh-eating bacteria scare me more than just about any sort of illness and this is from someone who beat a 50/50 chance of recovery from cancer and heart a-fib (successful ablation cured that). Thank God for the USCG our "guardian angels" on the water an in the air. I sail the Chesapeake Bay which is not clear water. Mostly green and or brown depending on how much rain washes fertilizer and God knows what else into the water. When heavy rains hit the Susquehanna River, upstream in PA, sometimes the sewage plants overflow into the water and that all heads down to the bay. Plus our infamous stinging sea nettles (jellyfish) which were numerous in the waters near my marina this past weekend. So I don't swim in the bay and when I use a dinghy to get ashore and that requires me to beach it I always wear waters shoes, never bare footed. Getting a cut and having bay water wash into it I'm sure is asking for a problem.

 

[Sean Engle]

Hawaii - what’s up with that place!?! I got an infection on Maui a few years ago that sent red streaks up my leg. Spent a day and a half getting IV antibiotics just so they’d let me fly home, then another course when back. Makes me love the high cold desert.

It's the tropics. We also have a friend whose mother retired at 60, so her son and his wife took her down to Costa Rica for a holiday. They went hiking at some point, and the mother tripped on a tree root, scraped one knee cap very minorly...and yep got a massive infection...that ended up killing her when she got home to Seattle.

Yeah. I grew up in NE Ohio and New England -- and love hard winters for a variety of reasons...and that's just one of them.

 

[southofvictor]

It's the tropics. We also have a friend whose mother retired at 60, so her son and his wife took her down to Costa Rica for a holiday. They went hiking at some point, and the mother tripped on a tree root, scraped one knee cap very minorly...and yep got a massive infection...that ended up killing her when she got home to Seattle.

Yeah. I grew up in NE Ohio and New England -- and love hard winters for a variety of reasons...and that's just one of them.

Yikes! At least if I’m going to freeze to death I can see it coming.