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  • Holly

Medical Matters

Accidents, heart attacks, sepsis…these are things that terrify me when it comes to living on a boat. In today’s blog I’ll talk about medical concerns and steps we are taking to be medically ready when we go sailing on a boat full time.

I’ve named my amygdala, I call it Steve Austin, anyone remember the Six Million Dollar man? That’s my brain’s fear center, fight or flight and it works really well. With its telescopic vision it can see things happen that no one else can see, even if they won’t even ever happen, that’s how fabulous my brain is. Until I scare the crap out of myself with visions of medical issues and accidents to the point where I seriously contemplate getting my appendix removed…that is not a joke by the way.

It started out us thinking about all the things that could go wrong and the boat and the first thing you think of is stuff like fires, drowning and abandon ship and all that…oh and of course shark attacks. Yes, there are things that will go wrong that would be terrible, but then there is the likelihood of something actually happening, which also needs to be considered. Based on all my research, and trust me, I’ve read the whole internet on this topic by now, the most likely risks are medical related, and have little to do with sharks. I’m not saying that drowning isn’t a risk. It is, and these risks can be minimized by wearing a life jacket and also not operating a boat inebriated from alcohol, or sailing outside your comfort and experience. What I’m saying is, it’s more likely for a medical issue to arise, than a fatal accident if you cover the basics of good seamanship. So as we are preparing to live aboard, just as we would practice man overboard, it’s prudent to also have a basic understanding of how to manage medical emergencies.

So of course the first thing we wanted to be sure of is how to avoid medical emergencies, which can be done with basic agreements like not boiling water under certain conditions or like Ryan and Sophie Sailing, they had a rule to wear a leather apron when cooking underway…but when she was burned by her coffee maker, it was of course that one time when she decided not to wear it. But we have to assume those things will happen, so what do you do next.

So the first place we turned was where to go to get some basic medical training. People rave about the Wilderness First Aid class so we looked into that first.

Here were the options:

  • Offshore First Aid - it requires nine hour of pre-reading and then it’s 3 full days. It is designed for voyaging sailors - yep, that’s gonna be us, sounds so adventurous doesn’t it. It’s offered once a year it looks like, and wouldn’t you know it, this year it falls on a week where I need to be in strategic planning meetings at work. People rave about it which is also why it sells out almost immediately every time it’s offered.

  • There’s Wilderness Medical First Aid: It comes in two flavors, a two day course and a four day course, but then you could also take the second flavor if you have to take a week off anyway, for 5 days, that’s the Wilderness Medical First Responder. And for the price difference and the extra day, it might be worth it. You’re there anyway. I’ve been told by a couple people now that this course is just okay but there are meaningful differences on a boat, so there’s that.

  • We looked at the STCW 1-4 and 1-2 courses in addition to the Safety courses because if you take them together, you can knock it all out at once. There seem to also be a number of courses like this offered in Europe that would also go towards his next RYA certification level for Yachtmaster Ocean. Right now he's a Yachtmaster. So if you are going for some kind of license, that’s something to consider.

  • Then one thing leads to another and the next thing you know I’m looking at how to get certified as an EMT…one of my character defects is I have a problem with boundaries.

  • We decided to stay focused and make sure we both did basic first aid and CPR, my husband had to do it for his RYA certification so he’s done. Then we will be looking to complete one of the Wilderness Classes at a minimum, with a preference for offshore of course. These could be either here or in Europe, we are considering one in the UK hopefully as our visa resets during the winter, that would go towards the training and his certification…but then we need to hope nothing major happens during our first season.

  • Meanwhile, the STCW basic courses for safety, firefighting and first aid are offered here in the bay area once a month at Cal Maritime. The downside is you have to go during weekdays which is rough if you work and all the individual classes are expensive and all add up.

Moving on. I bought a bunch of medical books and the one that I found the most valuable was the Wilderness & Rescue Medicine book by Jeffrey Isaac and David Johnson. I was told by the author when I was researching the subject to be sure to get the 6th edition. It wasn’t cheap but I read it cover to cover twice and it was really, really great. The reason I liked it is it explained why you assess for certain things, not just what to do, so as a layperson I could understand better the systems in the body and why it’s important to look for certain things. I can imagine this would be helpful in an emergency situation when half your brain shuts off. I thought this was really helpful if you can’t yet get to a course and would highly recommend this to someone.

That concludes our blog section about medical training, so I’m moving on now to discuss medical readiness and preparation.

My husband goes every year to get a full physical. I think he might be the only man on earth who does that. Until last year, I hadn’t had a full physical with all the bloodwork in…….I don’t know, since l had my second kid…which was…uh…21 years before that. Sure, I went to the doctor for this and that but a medical exam and full physical check-up isn’t something that doctors focus on. They fix things, they aren’t in the prevention business so they just don’t work that way. If you don’t ask for one, no one is looking over your shoulder to make sure you did it. As a woman, I have been getting my girly-parts inspected but on the wipers and the transmission, nothing under the hood or in the trunk if you know what I mean.

When I came face to face with this I was suddenly worried…like maybe there’s something I don’t even know about. A couple weeks later all my bloodwork came back and I’m lucky and had a clean bill of health. I’m really grateful for that, I’ll take it. Though the two benefits of turning 50 is you get to withhold more money in your 401K and you get the honor of a colonoscopy which is totally rad!

Dental work is marvelous

The next was the dentist, I do go for cleanings twice a year but don’t take their advice very seriously when they say, we are keeping our eye on this crown. I just sometimes feel like dentists are looking for problems and the out of pockets are so freaking expensive for luxury work. But a couple years ago I cracked a crown and had to get a root canal. I work in tech and we have this event every year that gives me insomnia and makes me grind my teeth at night. I started joking with my peers about it and I find out it’s a common thing for people who do what I do…go figure. Anyway, I recommitted to my dental plan to get my mouth figured out before I leave. Plus, if we live on the boat and are penniless when we get back and don’t have a job with insurance, I won’t have money to get anything fixed so I decided to do it all before I left. I have plans and I need my teeth.

Next was vaccinations. Do you know how hard it is to get a record of what you had done as a kid? And apparently you need that to go into certain countries it seems so we wanted to have it. Here’s some examples of what we will likely need at some point. Hepatitis A, hepatitis B, typhoid, yellow fever, rabies, meningitis, polio, measles, mumps and rubella (MMR), Tdap (tetanus, diphtheria and pertussis), chickenpox, shingles, pneumonia and influenza. I actually didn’t know there was a vaccine for shingles which is good to know. If you are anti-vaccine, you may not find this useful but I would urge you to watch the Chasing Bubbles documentary from 2016 about a sailor and then decide. You can find it on YouTube, it’s an hour and a half of your life and is both an inspiring and a tragic story. I cried my eyes out.

About medical prep and first aid kits. We have spoken to a doctor here in the area. There are doctors who will take all of your medical records and history and then gear you up with all the medicine and help you with emergency kit stuff. Then if something happens you can call them and get advice. This one doctor has a network all around major ports in the Med and the Caribbean so if something does happen there’s some place to go. Medical insurance is a different topic so I won’t cover that here. The one thing the doctors are saying they are more concerned about these days is the strange infections from bacteria due to the climate changes. He’s saying to wear shoes on beaches and not to go in the water if you have an open wound. I have a friend who got stung by a jellyfish in the Seychelles and then it got infected and turned into full blown sepsis. She was flown out and treated in the UK, then stabilized, came home and had the infection surgically removed and was in the hospital for more time to recover. She could have died.

On that note, let’s move on.

Finally, now to the tuff love…and I’m saying this out loud for myself more than for you as listeners. I’m lying to myself if I say I’m in good shape. I sit behind a desk all day on conference calls, or fly around and sit on airplanes or in airports and spend the rest of the time eating fancy meals with real butter (I’m a cheating vegan, I cheat mostly with fish and bread on business trips…well sourdough bread which technically I think qualifies but full of empty carbs). I’m good when I’m home with my diet but I maybe walk the dog or go on a hike a couple times a week.

I’m within the normal range for my BMI but if I’m truthful, like look in the mirror truthful, like dig down deep underneath the layers of delusion and stare my soul in the eyes truthful…I have work to do. If I had to wrestle with lines in a storm, pull Stephane up onto the boat, or swim 600 meters to shore for any reason I don’t want to be asking myself in that moment why I didn’t exercise more because Steve Austin will only take me so far. If you need motivation, read the book ‘Can’t Hurt Me’ by David Goggins, I've mentioned him before and after his book I signed up for a half-marathon, to keep me focused.

Well, first I signed up for a full marathon and realized it was ambitious so signed up for a half two months prior to that, which is within the realm of possibility since I have 5 months and have done one before. Then the full is two months later so we’ll see. I’ve been doing good so the books were worth the 1-credit on Audible. Oh, and I got an Apple Watch, which is really awesome by the way. It yells at me to do stuff…and gives me badges when I reach my goals like drink water and breathe, which I know, we shouldn’t need a watch to tell us to do. Shaking my head here. It sounds stupid but it actually works and every little bit helps. My husband on the other hand rides his bike to work 2-3 times a week and does all his other stuff including stretching because he has a level of self-discipline that mere mortals only aspire to.

What did I learn through this? It was a good reminder that our health is our number one asset, without it we don’t get to do this at all. The same is true in my day to day life but honestly going through this made me realize how much about my health I take for granted. I hide behind excuses like I have more important things to do, seriously, I’m not that important. President Obama had important things to do but he exercised almost every single day.

But…honestly and truly what is more important than taking care of my health that will ultimately help me live a longer more satisfying life. Not one single thing in the world.

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