Common Medical Complaints on a Sailboat
01-04-16
“The best cure for seasickness is to sit under a tree.”
Stan the Seagull sat on deck feeling.. not too clever
Lies, Damn Lies and Logistics
Instagram has been lying to you. Sailing off into the sunset isn’t all bronzed thighs, endless sunsets and turquoise seas. As if you didn’t know by now. It can sometimes be salt-stung eyes, rashes and fungus in places you’d rather not discuss, and the realisation that a sailboat can sometimes be a toe stubbing, head banging obstacle course, especially when you first set off.
You’d be forgiven for thinking your first-aid kit needs to be the size of a suitcase. It doesn’t. With kids onboard it needs to be 10X that. Only joking. But it's amazing how fast a simple “tiny scratch” can transform into something straight out of a pathology textbook.
With kids onboard your first-aid kit needs to be the size of a suitcase!
I’m not going to bang on about all the gruesome injuries and maladies we’ve had over the years (unless you really want to hear stories of abscesses and diarrhoea? Thought not). So, instead I’ll just rattle through the most common complaints, how to recognise them, treat them, or at least fend them off.
Roll the music!
Swimmer’s Ear
Darry picked this one up endlessly thanks to his obsession with free-diving. It’s when seawater hangs around in your ear canal, bacteria set up camp, and suddenly you’re deaf in one ear with pain so sharp it feels like someone is drilling into your skull. Not fun.
Irenka about to administer a 50/50 vinegar / rubbing alcohol solution to cure swimmers ear
Prevention: The best trick is to get rid of trapped water early. Shake your head all you like, but a couple of drops of rubbing alcohol mixed with vinegar after swimming does the job properly, evaporating the water and stopping bacteria before they move in.
Cure: If it’s too late, start with the vinegar/alcohol drops. Olive oil and cotton wool is an old cruiser’s remedy but doesn’t have much science behind it. If pain persists, it’s doctor time for antibiotic ear drops, and you’ll need to keep your head out of the water until it clears.
Shallow Water Blackout
We have met parents who have lost kids to this little known phenomenon so it bares mentioning. It happens when you hyperventilate before snorkelling and free-diving, tricking your body into thinking it has more oxygen than it does. You feel fine… then black out underwater with no warning.
Prevention: Never hyperventilate, always dive with a buddy, and know your limits.
Cure: Immediate rescue and CPR. If you’re lucky.
Sore Eyes
We once ploughed through a Saharan dust storm in the Red Sea. The stuff got into the winches, between our teeth, up our nostrils and worst of all our eyes. Combine dust, salt spray, blinding sun glare and the temptation to rub your face with engine-oily hands, and you’re looking at a miserable few days.
Stan suffering from itchy eyes - poor Stan
Prevention: Decent UV-blocking sunglasses are worth their weight in gold. They not only save your eyes but also let you see coral heads through glare. Add a wide-brimmed hat and, most importantly, don’t rub!
Cure: Saline rinses are the quickest relief, followed by cool compresses and hiding in a dark bunk for the evening.
Cuts, Scrapes, and the Saltwater Myth
Every sailboat is a floating obstacle course of sharp corners and trip hazards, and since most cruisers live barefoot your feet will soon look like you’ve been playing footsie with an angry chicken. There’s a myth that saltwater heals. It doesn’t. Saltwater is a soup of bacteria, algae and micro-nasties that can turn a scratch into a pus volcano in days.
Prevention: Slow down, wear appropriate footwear, and don’t run on decks or pontoons. Diving gloves and common sense go a long way.
Cure: Wash every cut with antiseptic even if it makes you yelp, cover it up, and do your best to keep it dry (which is almost impossible on a boat). Keep tetanus vaccinations up to date, and if infection sets in don’t muck about. Antibiotics are the next step.
Dehydration
It sneaks up faster than you think. You crawl into the engine bay for a sweaty job, or head off on an enthusiastic hike after weeks at sea, sweat buckets, and then toast your efforts with a cold beer instead of water. Suddenly your head is pounding, you’re making daft decisions, and your pee looks like lemon curd.
Stan suffering from dehydration
Prevention: Sip water constantly. Not beer, not coffee, but actual water. Then perhaps a cheeky beer afterwards. We kept individual water bottles topped up from a big cold bottle in the fridge.
Cure: Water, water, water. If you’ve really overdone it, rehydration salts help reset the balance.
Insect Bites
A perfect evening in the tropics: calm anchorage, cold drink, orange sunset.. and then the bloody mosquitoes, sandflies, and noseeums turn up. Within minutes your legs resemble the Braille edition of War and Peace, and occasionally you get dengue or malaria thrown in as a bonus prize.
Stan looking like a Braille edition of War and Peace.
Prevention: Bug screens are your first line of defence. Add long light clothing, DEET or other repellents, and coils (but don’t set them next to your mosquito nets!).
Cure: Antihistamines and hydrocortisone cream ease the itch. With kids, keep nails short so they can’t scratch bites raw and turn them septic.
Fungal Friends
Damp, heat and a lack of hot showers make a paradise for fungus. Athlete’s foot, ringworm, and jock itch all thrive in a sailboat cabin. Irenka once lost her hair to a particularly pernicious tinea capitis infection. It starts with a little itch and soon spreads like wildfire.
Prevention: Air your feet, wear sandals, dust with antifungal powder, and keep towels separate. And don’t let the kids put their feet on cushion or pillows.
Cure: Antifungal creams and powders work well if you catch it early. Persistent infections need proper prescription treatment though.
Athlete’s foot, ringworm, tinea capitis and jock itch all thrive in a sailboat cabin
Heat Rash
In the tropics your sweat glands can clog and revolt, leaving you with red, itchy pinprick rashes that make sleep impossible. It feels like being rolled in nettles.
Prevention: Shower regularly, dry properly and wear loose cotton clothes.
Cure: Talcum powder and calamine lotion help. Failing that, lie under a fan in your birthday suit.. in fact it’s nice to do that anyway on a hot afternoon as long as you’re not expecting guests over.
Diarrhoea
The glamorous side of long-term travel. It usually comes from shore food or from water tanks that have quietly turned into algae farms. Sometimes it’s a 24-hour misery, sometimes parasites like giardia move in and you become a human hosepipe for weeks.
Diarrhoea - sometimes it’s a 24-hour misery, sometimes you become a human hosepipe for weeks
Prevention: Filter or purify all drinking water, wash hands religiously, cook food thoroughly, and avoid suspicious salads or ice cubes of unknown origin.
Cure: Rehydration salts are essential, loperamide can buy you a break, and if it drags on, antibiotics again are your friend.
Ciguatera
Like Shallow Water Blackout this is on the rare side but nastier than your average case of food poisoning. Again, we have had buddy boat friends suffer from this so it deserves a mention. It comes from eating big reef fish that have built up toxins from algae. Symptoms can include vomiting, diarrhoea, tingling, hallucinations, and “hot–cold reversal” where ice feels like fire.
Ciguatera comes from eating reef fish that have built up toxins from algae
Prevention: Avoid barracuda, grouper and other large reef predators. Locals usually know which fish to trust.
Cure: None. Just misery, patience, and a vow never to eat reef fish again.
Stings & Coral Burn
Sea wasps, jellyfish and fire coral won’t kill you (usually), but they can ruin your day or even week. Coral cuts are the worst. They can get infected, itch like hell, and take a long time to heal.
Sea wasps, jellyfish and fire coral can itch like hell, and take a long time to heal.
Prevention: Reef shoes, rash vests and gloves help. Don’t bare-skin the reef, even with hands
Cure: Rinse stings with seawater, not fresh. Vinegar neutralises most jellyfish stings but not man-o’-war. Hot-water immersion reduces pain. For coral cuts, scrub debris out, disinfect thoroughly and monitor like a hawk. Again, keep the kids’ nails cut short.
Bruises, Sprains & Back Pain
After two weeks of cruising your body feels like it’s been through a tumble dryer. Booms, winches, dinghy pratfalls lower back strain. Every cruising guy I’ve ever met over the age of forty has more than a tale or two about crippling back pain. Why is it only the guys?
Prevention: Lift properly, stretch daily (call it Yoga if you like), and admit you’re not twenty any more.
Cure: Ibuprofen, ice, hot compresses and learning the local swear words very quickly.
Urinary Tract Infections
More common than sailors admit, especially in hot, sweaty climates where dehydration is rife. It burns, it nag and makes life thoroughly miserable, especially if you wake in the night, realise you’re in the yard, haven’t rehydrated properly all day and the nearest loo is a quarter mile away. Too many times. Way too many times.
Prevention: Hydrate well, practise good hygiene, and don’t hold it in.
Cure: Antibiotics. Quickly.
Skin Infections & Boils
As if cuts, insect bites, eczema or athlete's foot weren’t bad enough in the tropics, a hot, humid climate can transforms them into something even more irritating like boils, abscesses and cellulitis.
Prevention: Clean everything fastidiously.
Cure: Antibiotics and drainage if it gets dramatic. Do not squeeze “just to see what comes out.”
Dental Disasters
There are dentists in far-flung corners of the globe, and some are good quality and surprisingly affordable. But you might not want to test their drill skills in an emergency. Best to get every filling and crown sorted before you cast off.
Prevention: Check-ups before big passages, deal with little niggles early.
Cure: Clove oil, painkillers, antibiotics for infection, and prayers that the next port has someone half competent.
Seasickness
Sea-sickness is your brain freaking out over mixed signals and leading to nausea and vomiting
Sea-sickness is basically your brain freaking out over mixed signals, interpreting the mismatch between your ears and eyes as possible poisoning (like when hallucinogens disrupt balance and vision). Vomiting is triggered as a defensive reflex to clear “toxins” from the stomach. A reassuring factoid you can tell someone when they are in the middle of a full blown chunder.
Prevention: Pills, patches, wristbands, whatever works. Don’t hide below, get into fresh air, lie flat if you can.
Cure: Taking the helm and staring at the horizon helps reset the brain.
Sunburn & Sunstroke
Forget sunscreen once and you’ll be lobster-red, feverish and very sore. Sunstroke is nastier, with headaches, nausea, and the inability to string a sentence together. Think hangover, without the pleasure of partying the night before.
Forget to slip, slap, slop, seek, slide and you'll suffer from sunburn and sunstroke
Prevention: Follow the Aussie mantra: Slip on a shirt, Slop on sunscreen, Slap on a hat, Seek shade, Slide on sunnies. It works.
Cure: Aftersun, fluids and rehydration.
Hangovers
Not officially medical, but let’s be honest: half of cruising’s accidents start after sundowners. Falls into dinghies (and out), burns in the galley, stubbed toes on fittings.
Prevention: Easy on the sundowners, or at least a glass of water between each one.
Cure: Water, painkillers, and the traditional vow to never drink again. Until tomorrow night.
So Don’t forget the Gin
Phew, you can come out from behind the sofa now, we’re done!
Yes, cruising can sometimes feel like a catalogue of small medical disasters in exotic locations. Thankfully, most aren’t fatal, but left untreated they can become genuinely nasty. Just learn how to prevent the common ones, treat them when they happen, and recognise when it’s time to find a real doctor.. if you can.
Luckily, the cruising community is like a floating A&E. Snap an Achilles tendon and there’ll be an expert at the beach bar. Catch a tropical bug and you’ll end up sharing a sundowner with a disease specialist in Vanuatu. Cruising is weird like that.
But the truth is, the sea really doesn’t care for your welfare. It will happily fry you, sting you and cover you in rashes until you look like a biology experiment. So it’s up to you to stock your first-aid kit, learn your basics, and remember, ignorance won’t keep you safe, but knowledge (and a good supply of antiseptic creams, antibiotics, and gin) just might.
“Your Offshore Doctor: A Manual of Medical Self-Sufficiency at Sea” by Dr. Michael H. Beilan.
And, if curling up with a good medical book is your thing to really put the freighters up you, then try: “Your Offshore Doctor: A Manual of Medical Self-Sufficiency at Sea” by Dr. Michael H. Beilan.
If you want more straight-talking tales from life afloat, and information about common medical complaints on a sailboat, then you’ll love our upcoming book. We're inviting early readers to join the pre-launch crew and get behind-the-scenes access as we wrestle it into shape. It’s honest, unfiltered, and occasionally useful. Sign up here to get involved, give feedback, and be part of something that’ll either be a bestseller or a brilliant cautionary tale.
