Patients at sea – catch me if you can!
This time around Easter is a busy time for us with yachts coming back from the Caribbean and everyone preparing for the summer Mediterranean season of owner trips and charter guests. It makes for a lot of excitement catching up with people but also helping them sort medical queries which may have been on the back burner for a few months. It does beg the question as to how modern-day yachties achieve any continuity of care by one doctor who is familiar with the individual and their medical history.
Fortunately, one happy aspect of modern-day yachting is the relative ease of long-haul flights home – we have patients from Oz and New Zealand who get home at least once a year from the Med and the Caribbean. Some, on the other hand, prefer not to spend their holidays at dentists and doctors and there is no doubt that regular medical or dental check-ups can be squeezed out or missed completely.
At the ENG1 medical, I encourage an annual dental check to keep teeth in good condition and to avoid toothache at sea. Obviously it is better to have the same dentist each time but there are decent dentists in most ports and better not to sacrifice the check-up – some countries gain a reputation for cheap but good quality dentistry and this could be one perk of the itinerant lifestyle. If you are unfortunate and get toothache or lose a filling or break a tooth then a good quality on-board medical kit should contain a dental first aid kit with dental anaesthetic, dental cement or temporary filler to help out.
Well person medical check-ups, including pap smears and gynae checks, can be more complex and continuity of care with the same physician is ideal – second best is for the patient to keep a file of all correspondence and results. This is even more important when individuals have actually developed some symptoms of underlying illness but are obliged to move on. Efficient telecommunications mean that we have patients with medical problems who can still be advised whilst on the move and can then make better use of local facilities when next in a port. It is worth making sure you have enough stock of any medication for the next part of the voyage and a few weeks more. We are also aware of professional counsellors continuing to support their yachting patients to good effect whilst at sea.
The yachting population is generally positive and healthy and would probably rarely consult if they were living on-shore but there are still lifestyle patterns to be encouraged which will promote continuing good health. These include the predictable appeal to regular exercise, sensible diet, no smoking and moderate alcohol! Most boats have someone who can check blood pressure and urine once in a while and who have taken a Medical Care Onboard Ship Course ( Ship Captain’s Medical Course ) so that they can make some sense of unexpected symptoms of illness. Radiomedical advice is now increasingly supported by gadgetry to provide real time information to the 24/7 backup service and also can be loaded with modules for in-house crew refresher training.
Palma de Mallorca is a yachting hub and each day our patients are drawn from all over the world but good hand-held records and easy telecommunications combined with some on-board self help and medical support can overcome a lot of the short-comings for folk who never get home to be looked after.
Dr Ken Prudhoe, MCA Approved Doctor, can be contacted at Club de Mar Medical Centre, Palma de Mallorca.